Quick Answer
Yes. Medicare covers knee replacement surgery when it is medically necessary. Medicare Part A covers the inpatient hospital stay, including the operating room, anesthesia, and nursing care. Medicare Part B covers surgeon fees, pre-op visits, and outpatient follow-up care. You pay 20% coinsurance after meeting your deductibles.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Original Medicare (Part A & B) | Covered | Part A covers the hospital stay; Part B covers surgeon fees and outpatient follow-up |
| Medicare Advantage (Part C) | Covered | Must use in-network providers; copays and cost-sharing vary by plan |
| Medicare Supplement (Medigap) | Helps with Cost-Sharing | Covers Part A coinsurance and Part B 20% coinsurance, reducing your out-of-pocket costs |
| Medicare Part D | May Cover Related Rx | Covers pain medications and post-surgery prescriptions |
Understanding Your Coverage Options
Original Medicare (Part a & B)
Medicare Part A covers the inpatient hospital stay for knee replacement surgery, including the operating room, anesthesia, nursing care, and any inpatient rehabilitation. You pay the Part A inpatient deductible ($1,676 per benefit period in 2026) for the hospital stay.
Medicare Part B covers the surgeon's fees, pre-operative visits, and outpatient physical therapy after surgery. After meeting the Part B deductible ($257 in 2026), you pay 20% of the Medicare-approved amount for these services. As same-day outpatient knee replacements become more common, Part B also covers the procedure when performed in an approved outpatient setting.
Medicare Advantage (Part C)
Medicare Advantage plans cover knee replacement surgery, but you must use in-network hospitals and surgeons. Copays and cost-sharing vary by plan. Always verify that your surgeon and facility are in-network before scheduling your procedure to avoid unexpected costs.
Medicare Supplement (Medigap)
A Medigap plan such as Plan G covers the Part A hospital coinsurance and the Part B 20% coinsurance, significantly reducing your out-of-pocket costs for both the surgery and your recovery. Because knee replacement involves both inpatient and outpatient costs, Medigap coverage can save you thousands of dollars.
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is the Chief Technology Officer and Co-Founder of Elite Insurance Partners and MedicareFAQ.com. He is a member and regular contributor to Forbes Finance Council.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent in all 50 states dedicated to educating those eligible for Medicare. She trains agents on CMS compliance guidelines.