Insurance Coverage
Is shoulder replacement surgery covered by insurance?

Shoulder replacement surgery is covered by most insurance companies as well as Medicare and Medicaid. You should contact your insurance provider to see whether shoulder replacement is covered under your plan.

Click here to download a guide to the Insurance Coverage and Approval process.

This guide will assist you in navigating the insurance approval process. There are even tips on how to manage coverage issues.

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Can I afford shoulder replacement surgery?

Your insurance provider can help you determine what amounts are covered and what your liability, if any, would be. Here are some simple steps you can follow to find out more.

Step 1: Contact your health insurance provider and ask if shoulder replacement surgery is covered under your plan. Understand that only partial coverage of the operation is a possibility. If it is not completely covered, find out how much you will have to pay for.

Step 2: Find out how much the surgery will cost if you have no health insurance coverage. Get an estimated amount far in advance of your surgery so that you can look into your options.

Step 3: Consider applying for Medicaid, a government-funded health-care program. Many patients who undergo shoulder surgery fall between the ages of 65 and 70 years old, and may qualify for Medicaid. Also, if you are under 65 years old but have a low income, Medicaid may be an option.

Step 4: Your state government may have special health coverage options for low-income or elderly patients.

Step 5: Consider healthcare financing. Although most financing is available for cosmetic surgery or dentistry, check with lenders about options. Be sure to ask a lot of questions, read the fine print, and understand the interest rates, which may be higher than a normal loan.

Step 6: Take out a personal loan from your bank. You can save money on interest charges, but the bank may require you to complete a large amount of paperwork to finance your surgery.

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