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What is a hip replacement?
Your hips are important for everyday actions like standing and walking. Yet over time, parts of the hip joint may wear down. This can result in pain and eventual loss of movement. Hip joint replacement surgery (hip arthroplasty) is often used as a kind of hip pain treatment in these cases. This usually involves replacing damaged parts of the hip with ceramic or metal and plastic. There are several different types of hip replacement surgery:
- Total hip replacement – The ball and socket of your hip are both replaced.
- Partial hip replacement – Only the ball of your hip is replaced.
- Revision hip surgery – Surgery is used to replace the prosthetic from a previous hip replacement.
If hip pain causes major problems in your life, one of these surgeries may be right for you.
How much does hip replacement surgery cost with Medicare?
The cost of a hip implant varies depending on where you have your surgery done. At an ambulatory surgical center (a nonhospital facility for patients who need less than 24 hours of care), the average total hip replacement cost with Medicare is $2,140. In a hospital’s outpatient department, that average drops to $1,927. If you have your surgery at an inpatient facility, you’ll pay the Part A deductible of $1,676 for the first 60 days of your stay.
Which parts of Medicare cover hip operation costs?
Different parts of Medicare help with different parts of the hip replacement process.
Medicare Parts A and B cover surgery costs. If you have your surgery at an outpatient facility, your covered costs are paid by Part B. If you have it at an inpatient facility, those costs are paid by Part A.
Medicare Advantage (Part C) offers the same coverage as Parts A and B. But your exact costs may be different. With Medicare Advantage, your hip replacement may also be supported by other benefits.
Medicare Part D may help if your doctor prescribes drugs like pain medication after hip surgery.
A Medicare Supplement plan may help with some of the costs not fully covered by Parts A and B. This depends on your plan.
Does Medicare cover physical therapy for hip replacement?
Physical therapy for hip replacement patients is common. And Medicare may help cover some of these recovery costs. Part B helps pay for outpatient physical therapy if your doctor says you need it. Even if you’re slow to recover, there is no limit to how much Medicare will pay for this care each year. You may also qualify for care in a skilled nursing facility, rehab center, or for home-based care.
What are the steps of having Medicare help pay for hip replacement costs?
First, find a surgeon who accepts Medicare. Your surgeon will then find out whether a hip replacement is needed. If it is, Medicare will pay the covered amount. Medicare Part B also covers a second opinion if you want one.
