Joint replacement surgery involves long recovery times and support services, such as physical therapy and medical equipment. To avoid unanticipated bills, be sure to ask your health insurance provider and surgeon these important questions.
- What does your health plan cover for joint replacement surgery, including both physician fees and facility fees? Is the coverage different if you have surgery at a hospital versus a surgery center?
- Do you need a referral from your primary care physician before seeing an orthopedic specialist?
- Does the surgeon you are considering accept your specific health plan and product? (Ask this question when making your first appointment.)
- Does the hospital or surgery center your surgeon recommends accept your specific health plan and the product you have?
- Does your plan cover all needed services while in the hospital, including physical therapy?
- Does your plan cover prescribed medical equipment like a walker, crutches, support pillows and slings provided in the hospital?
- Does your plan cover medical equipment you might purchase before or after surgery, for use at home? This includes things like bedside toilets, grab bars and shower transfer benches.
- Does your plan cover physical and occupational therapy services you might receive at home, after you leave the hospital? If so, for how long? Are there limits on your coverage?
- Does your plan cover discharge to a rehabilitation facility if you do not have help at home from a family member or friend? If so, for how long? Are there limits on your coverage?
- Does your plan cover at‐home visits by care providers, such as home health aides, if you do not have help at home from a family member or friend?