Fees and Insurance

(Updated 10/25/2011)

II. Quick Reference for Insurance Coverage

C. Government Plans

I no longer participate with Medicare, Medicaid, Tricare, or workers compensation government plans.

If you are insured by these plans and you wish to purchase my services, we must enter into a private contract. The discounted fee schedule (see section IV) applies. All fees for surgical services must be paid in advance. Office-based services can be paid at the time of service. Most supplemental Medicare or Medicare replacement policies won’t pay anything to a provider who is opted out of Medicare. Hospital payments and other services that are not provided directly by my office will still be handled in the usual fashion by these government plans. These costs are typically the largest portion of any surgical procedure.

Example:

My fee for primary hip or knee replacement including the assistant fee: $5000
Hospital fees (approximately 20% $9000): $1800*
Anesthesiologist, radiologist and 
pathologist fees: $1250*
Supplemental Medicare policy covers some percentage of the $3050 (depends on your policy): $ ?

*These amounts are presented solely as estimates for illustration purposes. I have no control over the actual cost of these services.

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