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 ($1,736 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 ($283 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
Does Medicare Cover Both Knees if I Need Bilateral Replacement?
Does Medicare Cover Outpatient Knee Replacement?
Does Medicare Cover Physical Therapy after Knee Replacement?
How Much Will I Pay for Knee Replacement with Medicare?
David Haass
CTO & Co-FounderDavid 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.