Medicare Parts A and B cover hip replacement surgery when deemed medically necessary, but your costs depend on your plan coverage and other factors.
Original Medicare (Medicare Part A and Medicare Part B) can help cover specific costs of your hip replacement surgery.
| Medicare part | What’s covered? |
| Part A | Help with costs associated with the outpatient procedure, doctors’ fees, surgery, physical therapy and medical equipment (canes, etc.) |
| Part B | Help with costs associated with the outpatient procedure, doctors’ fees, surgery, physical therapy and medical equipment (canes, etc) |
| Part D | Post-operative drugs, such as prescribed medications for pain management or blood thinners |
Read on to learn more details about what to expect.
People typically need to stay in the hospital for 1 to 3 days following a hip replacement. As long as you have your procedure at a Medicare-approved hospital, Medicare Part A (hospital insurance) will help pay for:
- semi-private room
- meals
- nursing care
- drugs that are part of your inpatient treatment
If you need skilled nursing care following the procedure, Part A helps cover the first 100 days of care. This can include physical therapy (PT).
If your hip replacement is performed at an outpatient surgical facility, Medicare Part B (medical insurance) should help cover the costs of your care. Whether your surgery is done at a hospital or outpatient facility, Medicare Part B will typically help pay for:
- doctor’s fees (pre and post-op visits, post-op physical therapy, etc.)
- surgery
- durable medical equipment (cane, walker, etc.)
Medicare Part C, also known as Medicare Advantage, is required to cover at least as much as original Medicare (parts A and B).
Medicare Advantage plans may also offer additional benefits. These benefits may include nonemergency transportation to medical visits, meal delivery to your home after inpatient discharge, and other services you may need after hip replacement.
Medicare Part D is prescription drug coverage that can be purchased from a private insurance company separately from original Medicare. Part D typically covers the post-operative drugs that are not covered by Medicare, such as pain management medications and blood thinners (to prevent clotting) taken during your recovery.
According to the American Association of Hip and Knee Surgeons (AAHKS), the cost of a hip replacement in the US ranges from $30,000 to $112,000. Your doctor will be able to provide the Medicare-approved price for the specific treatment you need.
Before Medicare Part A and Part B pay any part of that price, you must have paid your premiums and deductibles. You will also have coinsurance or copayments.
- In 2024, the annual deductible for Medicare Part A is $1,632 when admitted to a hospital. This covers the first 60 days of hospital care in a benefit period.
- The monthly premium for Medicare Part B is $174.70, and the annual deductible for Medicare Part B is $240. Once those premiums and deductibles are paid, Medicare typically pays 80% of the costs, and you pay 20%.
Additional coverage
If you have additional coverage, such as a Medigap policy (Medicare Supplement Insurance), depending on the plan, some or all of your premiums, deductibles, and copays may be covered. Medigap policies are purchased through Medicare-approved private insurance companies.
Determining your cost
To find out how much your hip replacement will cost, talk with your doctor. The specific amount you’ll pay may depend on things such as:
- other insurance coverage you may have, such as a Medigap policy
- the amount your doctor charges
- whether or not your doctor accepts assignment (the Medicare-approved price)
- where you get the procedure, such as a Medicare-approved hospital
Hip replacement surgery is used to substitute diseased or damaged parts of a hip joint with new, artificial parts. This is done to:
- relieve pain
- restore hip joint functionality
- improve movement, such as walking
The new parts, typically made of stainless steel or titanium, replace the original hip joint surfaces. This artificial implant functions similarly to a regular hip.
According to the 2023 American Joint Replacement Registry Annual Report, the mean age of people getting a total hip replacement was 65.4 in 2022 (Medicare eligible).
What makes a hip replacement medically necessary?
The most common reason for a total hip replacement surgery is to alleviate severe pain from osteoarthritis of the hip joint. Other potential causes include rheumatoid arthritis and cancer.
Note that to get coverage from Medicare, your procedure has to fall under at least one of the following criteria:
- imaging or other clinical evidence of advanced joint disease like arthritis
- history of nonsurgical treatments that didn’t work
- pain and evidence of disability
- structural joint abnormalities
- a previous replacement procedure that failed
Learn more: Your guide to total hip replacement surgery.
Does Medicare pay for hip replacement rehab?
Yes. Medicare Part A covers in-patient rehabilitation, whereas Part B will cover any services you need once you’re discharged such as physical therapy.
How long does it take to recover from hip replacement surgery?
After hip replacement surgery, it’s typical to have pain or discomfort in your hip for 2-3 weeks. By 6 weeks, most people feel stronger with have
minimal pain, and this continues up to 3 months. By 6 months, most people generally recover, though this varies from person to person.
Original Medicare (Part A and Part B) will typically cover hip replacement surgery if medically necessary.
Your out-of-pocket costs for your hip replacement will be impacted by a number of variables, including:
- any other insurance, such as Medigap
- Medicare and other insurance deductibles, coinsurance, copays, and premiums
- doctor charges
- doctor acceptance of assignment
- where the procedure is performed