Does Medicare cover knee replacement?

Medicare Knee Replacement

In this Medigap Monday video, Robert Bache answers the question, “Does Medicare supplement plan G cover knee replacement?” Watch the video and discover how Medicare Supplement Plan G covers total knee replacement surgery. Then continue reading to learn how Medicare Plan G pays for your knee replacement recovery. Moreover, find out about surgical complications and inpatient costs.

Outpatient Knee Replacement

In most cases, knee replacement is an outpatient procedure. So, like every other outpatient procedure, Medicare covers 80% of your knee replacement costs.. If you have a Medicare supplement plan G, you pay $198 Part B deductible in 2020. Once you pay the annual one-time Part B deductible, the plan G supplement pays the remaining 20% of your outpatient procedures. Moreover, plan G covers your knee replacement recovery.

Knee Replacement Recovery

Recover from knee replacement often includes physical therapy rehab and doctor follow up visits. Since you already paid the Part B deductible and you have Medigap Plan G, you will not have any copays or follow up fees. As long as you go to a provider that accepts Medicare, 100% of all your outpatient medical services are covered. In some cases, knee replacement may result in surgical complications.

Does Medicare cover knee replacement - doctor and senior with knee condition
Doctor examines senior with a knee condition

Knee Replacement Complications

After outpatient knee replacement, you may have surgical complications. For example, according to Heathline, a small percentage of older adults may develop the following medical complications:

  • About 1 percent develop an infection
  • Less than 2 percent develop blood clots

 Moreover, anesthesia may cause the following adverse effects:

  • breathing difficulties
  • allergic reactions
  • nerve injury

If any of these medical conditions develop after knee surgery, a hospital may admit you as an impatient. 

Senior in a hospital bed after knee surgery

Inpatient Knee Replacement

Medicare Part A does cover 80% of your inpatient knee replacement cost after you pay the Part A deductible of $1408 in 2020. If you have Medigap Plan G, this Medicare supplement pays 100% of your Part A deductible. Furthermore, supplement plan G pays the 20% coinsurance not covered by Original Medicare. If you plan to have total knee replacement surgery, a Medicare Supplement Plan covers all the costs saving you lots of money.

How to Upgrade to a Medigap Plan

If you have Original Medicare, you can upgrade to a Medigap Plan by calling Senior Healthcare Direct at 1-855-368-4717 or get a quote. If you have Medicare Advantage, you have two Medigap Enrollment Periods.

Does Medicare cover knee replacement - before and after illustration
Knee replacement before and after illustration