Hip Replacement and Medicare coverage??? (benefits, deductible, surgeon, clinic)

[jean313]

I don't know if this is still an active forum, but for what it is worth, I can add our personal experience. My husband, who has Parkinson's disease (75 years old), had total anterior left hip replacement four weeks ago today on April 10 at Scottsdale Healthcare Thompson Peak and it was a positive experience from beginning to end. He was in the hospital three nights, then three weeks in rehab at Advanced Health Care Glendale. His difficulty getting out of bed at night to use the bathroom was the biggest reason for the rehab plus strengthening leg muscles that had been under used for 8 months. Today he started home health care PT to regain range of motion and flexibility. He had been inactive since October when pain from bone death after previous hip repair was so bad he could hardly move. It will be totally covered by original Medicare and AARP supplemental insurance. We have no co-pays. His surgeon, Dr. Kurtis Staples and anesthesiologist, Dr. Silver, were superb in all ways and did not take his Parkinson's disease risks lightly. He is walking without assistance but carries a cane for the Parkinson's occasional imbalance. We highly recommend both the hospital and rehab facility.

[pnwretired]

So glad you had good experience. Good info for people who live there.

[AZgarden]

Jean: Yes, thank you for the info. Am still having considerable problems and this is helpful to know, since I could easily use Scottsdale Healthcare and your doc. Appreciate the good info and hope your hubby is recuperating nicely.

[thankingmomMcCoy]

Hello Charleseelliot, Can you please tell me the plan that paid 100% I am now picking out a plan and need a replacement. Thank You so much!

[Ariadne22]

Originally Posted by thankingmomMcCoy

Hello Charleseelliot, Can you please tell me the plan that paid 100%

She already answered that, here:

Originally Posted by Charleselliot

Medicare supplements and immediately signed her up for a Plan F

There are many carriers in every state which offer Medigap Supplement Plan F.

Medigap Plan F - no matter the carrier - pays the remaining 20% of any Medicare-approved charge not paid by Medicare.

Premiums vary considerably by state and insurance carrier.

Go to Medicare.gov, search out Medigaps for your ZIPCODE. Then call the company.

Or, see a health insurance broker in your area specializing in Medigap coverage.

[linwood1095]

Thanks to all who have posted. Very valuable info here. Very encouraging too. I think I need a left hip replacement but I'm waiting until April of 2016 when I turn 65. I had Medicaid because we are raising 2 Grandchildren, but then the rules changed so here I am, no insurance and Obama Care is a complete joke. The only thing it did was make ignorant people aware of Medicaid. Turned out to be just another way for the liberals to run our lives. And spread the wealthier peoples money around to people that don't deserve it.

If and when I get the hip surgery I'll try to post the results.

[JRR]

I had my left hip replaced on August 25th. Spent two nights in the hospital then came home. 8 visits by in home therapy then on my own. Everything seems to be progressing fine.

I have a High Deductible F Medicare supplement so I will be responsible for $2180 for 2015. Haven't seen the hospital bill yet. Kind of amazed at how little my surgeon received for the replacement; $1433.

[terry nevitt]

I am having total left hip replacement this august.I am having this done as out patient. I just got on medicare, I missed open enrollment for a rider plan,I am having this done in ky.What can I expect to pay out of pocket after medicare's 80 percent. thank's

[Ariadne22]

Originally Posted by terry nevitt

I am having total left hip replacement this august.I am having this done as out patient. I just got on medicare, I missed open enrollment for a rider plan,I am having this done in ky.What can I expect to pay out of pocket after medicare's 80 percent.

Costs vary by area and provider and your circumstances. KY should be on the lower end of this range:

Medicare spends an average of $16,500 to $33,000 per patient for the surgery, hospitalization, and recovery from hip and knee replacements, but depending on the provider and where the treatment takes place, the quality and cost of these surgeries can vary greatly. The rate of complications such as infections or implant failures after surgery can be more than three times higher at some facilities than others. This can lead to patients being readmitted to the hospital, driving up costs even further.

The Payment Reform Landscape: Why Medicare

https://innovation.cms.gov/initiatives/CJR

So, figure at least $3,300. Lion's share will be owed to the hospital - which should be willing to arrange a payment plan if you need it.

[jaminhealth]

I have straight Medicare for at least 10 yrs and had a THR in 2010, Medicare came thru good and I had copays that I made payments to. I still owe hospital but they can wait. out patient is very brave. I was in hospital 3 nights, can't imagine outpatient, but hope you will be good. Hope you are one of the fortunate ones with this surgery, mine is another story.

Too bad insurance won't pay for PRP and Stem Cells, this could save a lot from surgery and large amounts of $$$$$$. But that's another topic.

My surgeon billed medicare $21K for anterior but Medicare paid him $2100. Medicare has schedules of payment. I had to pay him some $300 in copays which I did over some months. Also all the assisting medical people who drop in to see you and charge medicare. They all get their money somehow.


Back when I went on Medicare there were NO options like today as I understand it. One either went with straight medicare, bought a costly monthly supplement and I think went to an HMO like kaiser or the others. Personally, I would NOT be in an HMO, I like to pick and choose my doctors and am prepared to pay copays and very often they are affordable...FOR ME. Sometimes I think the more insurance one has the more they can go after. Just my thinking and experiences. So much has changed in the 10 yrs since I joined and costs have gone up as usual.