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Every year, doctors perform an estimated 600,000 knee replacement surgeries on adults in the United States alone. A knee replacement procedure, sometimes referred to as a knee arthroplasty, is a bone surgery that is meant to decrease pain in the knee caused by arthritis or an injury after other less invasive procedures have no effect. It is more common among aged individuals.
During the procedure, the damaged portion of the knee joint is carved out and replaced with an artificial joint made of metal or plastic. Successful knee replacements allow patients to move more freely and remain active well into their old age, but the procedure comes at a hefty cost.
Average Cost of Knee Replacement Surgery
For a total knee replacement surgery, patients can expect an average cost of just under $50,000, although the final bill is dependent on several factors. Knee replacement surgery costs vary based on the number of days a patient is required to stay in the hospital post-operation, the type of implant used, any pre-existing conditions that may complicate the surgery, and care and recovery after the procedure is done.
Fortunately, individuals who have health care insurance usually do not pay the full knee replacement cost. However, there are still costs like a health insurance deductible, physical therapy or follow up visit co-pays, prescriptions, and expenses not covered by insurance that must be paid out of pocket.
To get a better understanding of what surgery will cost out of pocket for those with insurance coverage, it is beneficial to speak with the insurance provider to get a knee replacement cost estimate before going under the knife.
Financing Options for Patients
For individuals who require a knee replacement surgery but do not have insurance, evaluating financing options prior to undergoing surgery is necessary. Here are a few options for covering the cost of knee replacement surgery.
Medical Bill Payment Plans
Some healthcare providers offer medical bill payment plans as a way to help patients pay for knee replacement surgery over time. Instead of paying the entire bill at once, payment plans break up the total amount due over the course of several months or even years, making repayment more affordable. Patients should speak with their healthcare provider to see what payment plans are available, if interest is charged, and any other specifics of the repayment terms that may be included.
Paying for out-of-pocket costs associated with knee replacement surgery may also be accomplished through a personal loan. This type of borrowing involves receiving a lump sum from a lender, typically a bank or credit union, which the patient then pays to the healthcare provider. Monthly, fixed payments are made to the lender over the course of several months or years, providing predictability to repayment. Most personal loans have fixed interest rates which also helps with budgeting for repayment.
Accounts like lines of credit and credit cards may also be used to pay for knee replacement surgery costs. While these types of funding are available, they carry variable interest rates which may increase over time. Interest rates on revolving accounts are also higher than fixed personal loans, increasing the total cost of repayment.
Financially Preparing for Major Medical Expenses
If knee surgery is imminent, individuals can plan ahead to help offset the out-of-pocket costs associated with the surgery. First, having a medical emergency fund is helpful in paying for medical bills that come due post-procedure, but it can take time to build up enough to cover the knee replacement cost in full. Keep a medical emergency fund in a safe, liquid account, like a high-yield savings account or money market savings for easy access when the time comes.
In addition to setting money aside into savings, individuals who need knee replacement surgery can and should shop around for lower costs with various providers. Each facility offering knee replacement has its own set of pricing guidelines, and failing to compare these costs could ultimately cost the patient more in the long run.
Patients also have the opportunity to negotiate discounts with the provider of choice, especially when insurance isn’t in place or won’t fully cover the bill. Ask the healthcare provider what reductions in cost are available before scheduling the surgery, and be sure to get any applicable discounts or reductions in writing.
Knee replacement surgery can be a costly event for those who do not have comprehensive health insurance coverage before undergoing the procedure. The steps listed here, including evaluating financing options, setting aside savings in advance, shopping various providers, and asking for discounts all work to reduce the total out-of-pocket cost for knee replacement surgery.
Author: Jeff Gitlen