Dr. Bates shares if insurance will cover a woman’s hip replacement.
At this time, most insurances will cover a hip replacement. I think more importantly, does your doctor accept your insurance, which is a big issue here in Southern California. It’s becoming a bigger issue nationwide. It’s even a concern amongst the Medicare population where most of our joint replacements come from because Medicare’s reimbursement rates have substantially declined over the last years as our costs of doing business, i.e., our overhead, our bills, our ability to pay our employees increases. So, the current reimbursement in our county for a hip or knee replacement is approximately $1500.00.
Now when you take away the overhead that we pay to run our offices and then you give your bit to Uncle Sam, you are left with very little. So some physicians have opted out of Medicare, meaning they have no longer agreed to participate in the Medicare program, and that leaves a lot of elderly patients without the ability to go see a quality physician.
Currently many joint replacement doctors still opt in to Medicare, but as things continue to worsen that could change, and that’s a concern that is well known amongst the orthopedic community, and hopefully the public will start to become more aware of our dilemma in regard to this.
About Dr. Bates, M.D.:
Dr. James E. Bates, M.D., is a board-certified orthopedic surgeon specializing in joint replacement surgery and sports medicine at Alvarado Hospital. Dr. Bates places his focus in sports medicine and the reconstruction and replacement of damaged bones, joints, and cartilage resulting from sports injuries, traumatic injuries, and tumors of the extremities. He was trained at the Hospital for Special Surgery/Cornell University Medical Center and Memorial Sloan Kettering Cancer Center in New York. As an orthopedic surgeon, Navy Flight Surgeon, and Navy Diving Medical Officer, he serves as a consultant to the San Diego-based Navy SEAL Teams.