Howard Marans MD: Are All Knee Surgeries Covered By Insurance?

In some cases, the best way to treat a knee injury is with surgery. Many patients are anxious about surgery, not least because of the potential cost. Fortunately, it is possible to get knee surgeries covered by insurance in most cases, which helps keep patients’ costs down; in addition, getting necessary treatment now can go a long way towards minimizing future medical bills. Below, we will explore some basics about knee surgery in general and knee surgeries covered by insurance in particular.

When Knee Surgery is Necessary

In the majority of knee problems, knee surgery is not necessary. Physical therapy, medication, and other non-invasive methods can often resolve knee injuries without the need for invasive procedures. If non-surgical methods are ineffective or if the damage to the knee is extensive, then surgery may be necessary.

How Knee Surgery Works

Most knee surgeries can now be performed using arthroscopic surgery, a minimally invasive surgery in which only small incisions are made, and cameras are used to view the inside of the joint. Arthroscopic surgery is associated with shorter recovery times, a lower risk of side effects, and lower costs. In some cases, such as knee replacement surgery, it is still necessary to perform traditional open joint surgery.

Knee Surgeries Covered by Insurance

Regardless of the nature of the knee surgery, it should be possible to get knee surgeries covered by insurance. Your doctor will only recommend knee surgery if it is medically necessary, and health insurance covers medically necessary procedures. Thanks to the changes brought by the Affordable Care Act, even knee problems that existed before you were insured should be covered.

This means that the biggest factor that influences how much you pay out of pocket is your insurance policy. If you have a high deductible and copay, you may pay a large portion of the cost of surgery out of pocket, while patients with lower deductibles but higher premiums may pay very little. If you are not sure about how your insurance covers the procedure you need, you should contact your insurance provider for more information.

Financing Options

In cases where the patient’s out of pocket costs are still relatively high after insurance is applied, financing options are available to help spread the cost of treatment over a longer period of time. Your financing options include patient financing companies, health care or traditional credit cards, and loans or lines of credit. Your own preferences and your financial situation will determine which type of financing is right for you.

Dr. Howard Marans would be happy to meet with you about your knee health. To schedule your consultation today, please click below and enter your information or call OC Orthopedic at (714) 979-8981.