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The Cost of Knee Replacement Surgery - What Factors You Should Consider

You likely have a long list of questions and concerns if you've been considering knee replacement surgery. The planning phase can be overwhelming, and many patients worry about the cost. Learning about the essential factors affecting knee replacement surgery costs can help you make an informed decision.

Get in touch with an experienced orthopedic surgeon like to discuss your surgical procedure and the total amount you’ll spend. Continue reading this piece if you want the best outcome in terms of health and money.

What You Need to Know about the Cost of Knee Replacement Surgeries

Understanding that the costs depend on various factors is critical before setting a budget. You also need to know that it largely depends on your specific case and orthopedic needs. Some major factors affecting the cost include your choice of the surgery center, surgeon, cost of surgical instruments, and the procedure.

On average, a knee replacement surgery costs around $35,000. Patients paying out of their pocket can often negotiate with the healthcare provider to receive a self-pay discount.

On the other hand, the costs are significantly different for patients with a private health plan. The same applies to those whose hospital bills are covered by an employer. In simpler terms, your out-of-pocket will automatically reduce to a significant extent with insurance. That said, make sure your orthopedic surgery complies with the health plan.

What Does Insurance Typically Cover?

Typically, health insurance aims to lower the costs for both the patients and the healthcare system. The goal is accomplished when payment is made in a single entity, allowing negotiation with providers. Many patients can also avail themselves of the option of receiving aid from the health insurance their employer provides.

If your workplace doesn’t cover your hospital bills, you can purchase a private health insurance plan to finance your knee replacement surgery. Uninsured patients can get their insurance on healthcare exchange packages supported by the ACA or Affordable Care Act. Older patients near or in retirement can finance their surgery through a state-sponsored Medicare system. Then, they can supplement it with a private insurance plan.

Patients using private health insurance make monthly payments that cover them under the specific health plan. Remember, you also have to pay an insurance deductible. It is the amount insured people pay out of their pocket before the insurance company provides services to cover hospital expenses. After that, you must pay a co-insurance amount or a portion of the expenses until you reach the maximum limit of the out-of-pocket payments. Ideally, the insurance covers 80 percent of the surgery expenses while the patient pays for the rest of the 20 percent.

Furthermore, health insurance providers usually have a network of healthcare providers. You can get your surgery at a lower rate if you pick a surgery center covered by the company.

Bottom Line

Knee replacement surgery can help restore flexibility and mobility, but it can be costly. Get in touch with a professional like Dr. Hill to discuss the best plan and get a quote. Book your appointment today.


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