How to Discover If Your Insurance Covers Knee Surgery

Knee surgery is one of the most common operations currently performed. Most insurance companies cover knee surgery. There are many different reasons for performing knee surgery and a great variety of procedures to address those reasons. Before embarking on a course of treatment, discover if your insurance covers the particular operation you may need.

Difficulty: Easy

Instructions

Discover If Your Insurance Covers Knee Surgery

1. Discuss with your doctor the exact type of problem you have which requires knee surgery.

2. Write down both the diagnosis of your problem and the type or types of knee surgery recommended to solve the problem.

3. Read your insurance coverage booklet before speaking with your insurance company.

4. Speak with your company's benefits manager to discover if your insurance covers the procedure you require.

5. Call your insurance provider for details about coverage for knee surgery.

6. Ask your provider if it will pay for more than one surgical procedure on the same knee.

7. Nail down the amount paid for rehabilitation and drug therapy.

8. Know the length of time your insurance company allows you to stay in the hospital for your procedure. Find out if the insurance company or the doctor decided on the appropriate hospital stay and whether or not a private room is covered under your policy.

9. Find out if braces, crutches and other rehabilitative equipment are covered by your insurance.

10. Investigate the possibility of insurance coverage for transportation to and from the hospital during your recovery.

11. Research options for in-home physical therapy, which may be covered by your insurance.

12. Work with professionals in your doctor's office to prepare a complete surgery and rehabilitation plan.

13. Authorize the treatment plan in advance. Have your doctor's insurance representative receive written confirmation of the authorization.

14. Check with your insurance company personally 1 to 2 weeks before surgery to make sure that all requirements for coverage have been fulfilled.

15. Maintain a file of all correspondence between you and your insurance company pertaining to your knee surgery.

Tips & Warnings

• If your surgery is elective, consider putting it off until the next calendar year.
• Immediately enroll in any pre-tax insurance programs offered by your company.
• Pre-tax dollars saved in a company program can be used for deductibles, co-payments and other expenses incurred during your knee surgery.
• Sign up for insurance programs which pay cash in addition to your standard insurance benefits.
• Most insurance companies limit the procedures that can be done to correct any one problem. If a second more complete operation on the same joint is required it may not be fully covered by insurance.

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