Knee Surgery, have it done while insured or while on Medicare?

[LFP57]

Hello,

I retired about a year ago, I'm still working, I have medical insurance and have already enrolled in Medicare. I'm looking at having a full knee replacment after having tried both type of injections and not getting any positive results. My plan is to retire completley in about 6-8 months, once I have the surgery, my job is gone, considering having it done at the very end of working or wait until after I retire. So now I'm looking for some feed back from those that had it done under insurance or through Medicare.

 

[GreensvilleJay]

get it done ASAP ! At least BOOK the surgery. Up here ,can take 2-3-5 YEARS to 'go under the knife'.
Better to be healthy not wealthy, and really 1/2 year of paychecks shouldn't be that 'cash critical'.

 

[DustyRusty]

First you need to understand how Medicare works. You will have a 20% copay for the doctors bills. Not all doctors accept Medicare benefits, so you will need to check to see if the doctor that you prefer accepts Medicare. Also, depending on the plan that you subscribe to there are location limitations. It can become quite confusing for the first time Medicare beneficiary, so I suggest that you contact one of the Medicare benefits programs and discuss it with them. Every year I have to go through the same thing because plans change as well as benefits. You will also need to purchase a drug plan since Medicare doesn't include drugs, but some plans do.
If you presently have a good plan through your work, I would see how much they will cover for the surgery and what your out of pocket expenses are going to be. Just keep in mind that the 20% copay can add up to a lot of money quickly. I had a hip surgery 2 years ago this January, and it was 3 days in the hospital because of complications, 3 weeks in rehab, 8 weeks of physical therapy, and another 8 weeks of chiropractic adjustments after I tripped and fell. My plan covers everything that Medicare doesn't, but it is also expensive. Weigh your options carefully.

AARP's Medicare Q&A Tool

AARP's Medicare Question and Answer Tool provides you with fast access to the answers you have about how the program works.

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How Much Will Medicare Part A Pay for Hospital Costs?

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[lynnmor]

My wife and I have three new knees between us and are using Medicare Advantage. I am pleased to report that the medical bills were easily managed. We have the zero payment plans and know that catastrophic events might cause some high bills but for the past 12 years on it we are far ahead of the game despite a fair amount of medical attention. Go to Medicare.gov and compare the plans available in your area, the Medicare Advantage plans are somewhat hidden but they are there.

 

[skeets]

And make sure whom ever you choose to do the knee replacement has good people in the office to cover the paper work in detail for your medical provider. I know this because when I had mine done, they missed a couple things on the paper work, and I had a bunch of out of pocket, and then had to file a claim , and it was a nightmare at best.
However as I understand there are new and improved ways of doing it other than cutting your leg in half and hammering it back together with a U joint, and recovery is a lot faster. Do your homework first and do not assume anything when it comes to medical coverage,, and all the best

 

[fried1765]

get it done ASAP ! At least BOOK the surgery. Up here ,can take 2-3-5 YEARS to 'go under the knife'.
Better to be healthy not wealthy, and really 1/2 year of paychecks shouldn't be that 'cash critical'.

The ABSURD wait times you describe, are simply a feature of the ( get it if/and when you can ) Canadian medical system!
Should only be a month or less, wait in the USA, no matter which insurance system you choose.

 

[GreensvilleJay]

yup, we have 'too many chiefs and not enough indians' , up here north of the 49th !

too many very highly paid '3 letters' supposedly doing a great job running the hospitals yet need 1,000s of nurses, doctors and support staff.

 

[Moose7060]

The ABSURD wait times you describe, are a ONLY a feature of the ( get it if/and when you can ) Canadian medical system!
Should only be a month or two wait in the USA, no matter which insurance system you choose.

My wife and I both have had total knee replacements. Less than a year wait for both of us. Had it been an injury that caused immobility it would have been much sooner. I don't think they pay enough taxes in Ontario.

 

[Poohbear]

I had my both of my knee replacements using plain MC on the 1st in 2017 then useing MC Advantage on the last at the end of this last Dec.
I only had a week wait on this last one and the 1st replacement saw doc on a Monday and on table the next day. Stayed in hospitol 3 nights on 1st one and in Dec arrived at 7:00am and was home at 4:15pm.Rehab about the same
My advice is don't wait. If you can't retire now for what ever reason you can't either in 6 months imo. Lifes to short to not have your health. My wife is dealing with Parkinsons and AFIB which isn't a fun way to be retired. AFIBs under control now thanks to getting a pacemaker Tuesday

 

[fried1765]

My wife and I both have had total knee replacements. Less than a year wait for both of us. Had it been an injury that caused immobility it would have been much sooner. I don't think they pay enough taxes in Ontario.

I needed a 9 pole power line installation at my Nova Scotia property.
The lineman inspector needed to be able to climb for inspections.
He arrived in a pickup, to only do the pole layout (on the ground).
Explained that he was on "light duty", expected two year wait for knee surgery.
A 55 year old, in the prime years of his working life!

 

[Moose7060]

I needed a 9 pole power line installation at my Nova Scotia property.
The lineman inspector needed to be able to climb for inspections.
He arrived in a pickup, to only do the pole layout (on the ground).
Explained that he was on "light duty", expected two year wait for knee surgery.
A 55 year old, in the prime years of his working life!

Health care is Provincial, not Federal. Every Province is different.

Apologies to the OP for your thread being hijacked. Hope your surgery is successful and a quick recovery regardless of which method you choose.

 

[GeoHorn]

When I scheduled my procedure (while I was still employed and insured and wanted to have that benefit)….the doctor suggested that I wait 3 months until I retire and go on Medicare…(with an “Advantage” co-insurance)…because the doctor said it would cost me less.

He was correct. I WOULD have had to pay a deductible…but on Medicare with my Advantage plan. being “primary”…it was Zero Deductible, Zero Co-pay… and it’s been that way now for ten years.
Anytime I or the wife need care…either regular Dr. stuff…or ER…. it’s walk-in..Zero Ded/Zero Co-pay.

Of course ..that may change when America is Great Again.

 

[fried1765]

Health care is Provincial, not Federal. Every Province is different.

Apologies to the OP for your thread being hijacked. Hope your surgery is successful and a quick recovery regardless of which method you choose.

So,.......in some provinces it is bad (time), and in other provinces, it is even more badder?

 

[Moose7060]

So,.......in some provinces it is bad (time), and in other provinces, it is even more badder?

No, better once you left the country.

 

[WFM]

They have hockey, maple syrup, high taxes and horrible heath care. I'll stay put.

 

[Moose7060]

They have hockey, maple syrup, high taxes and horrible heath care. I'll stay put.

Don't forget better education. Health is spelled with an "l"

 

[WFM]

Hahaha

 

[BAP]

Hello,

I retired about a year ago, I'm still working, I have medical insurance and have already enrolled in Medicare. I'm looking at having a full knee replacment after having tried both type of injections and not getting any positive results. My plan is to retire completley in about 6-8 months, once I have the surgery, my job is gone, considering having it done at the very end of working or wait until after I retire. So now I'm looking for some feed back from those that had it done under insurance or through Medicare.

Talk to the people at the doctors office that deal with insurance billing and ask them if they know. Many of them or even the doctor themselves, have a lot of experience with insurance and may be able to give you the advice you need. The doctors themselves a lot of times, know how to code and bill things to work around the insurance intricacies that make no sense in order to get something covered.

 

[D2Cat]

Depending on the MC you have be sure to check with the hospital/Dr. right before the surgery to confirm they do accept MC. They change and you never find out until it's too late.

 

[LFP57]

I had my both of my knee replacements using plain MC on the 1st in 2017 then useing MC Advantage on the last at the end of this last Dec.
I only had a week wait on this last one and the 1st replacement saw doc on a Monday and on table the next day. Stayed in hospitol 3 nights on 1st one and in Dec arrived at 7:00am and was home at 4:15pm.Rehab about the same
My advice is don't wait. If you can't retire now for what ever reason you can't either in 6 months imo. Lifes to short to not have your health. My wife is dealing with Parkinsons and AFIB which isn't a fun way to be retired. AFIBs under control now thanks to getting a pacemaker Tuesday

I can retire anytime, my wife will not have insurance and she's too young for Medicare/ Social Security, in six months she'll quality for Social Security and then we'll get her insured. My job is not that stressful on my body, I can take it easy and wait until she is covered.