Knee replacement costs and how to pay for them
You and your doctor have come to the same conclusion: you can’t put off knee replacement surgery any longer. But even though it may have taken months or even years to get to this moment, that’s really the easy part. Now you’ve got to figure out how to pay for it. Even if you have good insurance, there could be a lot of out-of-pocket costs.
Joint-replacement has gone from science-fiction to a common medical procedure in many of our lifetimes. Every year there are about 720,000 knee replacements and 330,000 hip replacements in the United States. Ask around at work or a family gathering. Chances are you’ll find someone who’s had one or knows someone who’s had one.
The relief that joint replacement brings is real. And the costs? They’re just as real, too, unfortunately.
How much will you pay for knee replacement surgery, even if you have insurance?
The average cost for a total knee replacement in the United States is $57,000.
Using guidance on typical coverage levels from healthcare.gov, let’s assume your annual deductible is $1,300, your co-insurance is 20% and your maximum annual out-of-pocket cost is $4,400 a year.
While $4,400 is a whole lot less than $57,000, coming up with the money to pay it could be difficult. And, remember, that’s just an example. It’s not uncommon for annual maximum out-of-pocket costs to be even higher.
How to pay for your knee replacement surgery out-of-pocket costs
Plan your knee replacement surgery costs with these 3 steps:
- Determine exactly what your out-of-pocket cost will be. Your insurance provider or your employer’s Human Resources department can help plan out what the final cost will be. Don’t wait for the bills to arrive: Know in advance what your share of the cost will be.
- Identify how you will pay that bill. Do you have enough cash on hand? Can a family member help out with a loan? Should you max out your credit cards? Or might a personal loan make sense for you? If so, see below how LendingPoint could be the right answer for your needs.
- Move as quickly as you can to get your payment plan in place. Recent changes in rules that affect how your credit score is computed provide some short-term relief from negative effects caused by medical debt collection. Still, this additional debt will undoubtedly put pressures on your ability to meet other financial obligations. The last thing you want to do is start missing payments and do damage to your credit rating.
Why are out-of-pocket costs rising overall?
In 2017, more people have health insurance than did in previous years. But the costs for that coverage continue to rise. The cost of healthcare for a typical American family of four covered by an average employer-sponsored preferred provider organization (PPO) plan is now $26,944 according to figures released in the 2017 Milliman Medical Index.
In addition to premiums, many plans also have deductibles — an amount you will pay first before much of the insurance benefit kicks in — and maximum out-of-pocket expenses — a higher amount that is the most you will pay for healthcare in any given year. In recent years, while premium cost increases have slowed, deductibles and maximum out-of-pocket costs have risen steadily, according to The Kaiser Family Foundation (KFF).
KFF says the cost of healthcare is causing difficulty with the personal finances of people across the United States, even those who have health insurance. “Overall, about a quarter (26 percent) of U.S. adults ages 18-64 say they or someone in their household had problems paying or an inability to pay medical bills in the past 12 months. People from all walks of life can and do experience difficulty paying medical bills.”
66% of those bills come from a one-time medical event, according to KFF. To pay for those bills, 77% of insured households with high medical bills postpone vacations or major purchases, 63% use all or part of their savings and 31% tap their retirement accounts.
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