BlueCross BlueShield Hip & Knee Replacement — Palm Beach County
BlueCross BlueShield Coverage for Hip & Knee Replacement
Dr. Robert J. Avino is a board-certified, fellowship-trained orthopedic surgeon accepting BlueCross BlueShield insurance for evaluation and treatment of hip arthritis, knee arthritis, and degenerative joint disease — including robotic-assisted hip and knee replacement using Mako technology.
BCBS Accepted
1,000+ Robotic Procedures
Board Certified & Fellowship Trained
BlueCross BlueShield Plans Accepted for Joint Replacement
Dr. Avino accepts BlueCross BlueShield insurance for evaluation and treatment of hip and knee arthritis, including joint replacement surgery when medically appropriate. Multiple BCBS plan types may provide coverage.
BCBS Commercial Plans
BlueCross BlueShield commercial and employer-sponsored plans commonly include coverage for joint replacement surgery when the procedure is determined to be medically necessary based on diagnosis and prior treatment history.
BCBS Medicare Advantage
BlueCross BlueShield Medicare Advantage plans may cover joint replacement surgery for eligible Medicare beneficiaries. Benefits and cost-sharing vary by specific plan — calling the office to verify coverage is recommended before scheduling.
Verify Your Plan
Coverage details — including deductibles, copays, authorization requirements, and referral requirements — vary by individual BCBS plan. The office can help confirm your specific benefits when scheduling.
Coverage details vary depending on the individual plan and the patient’s specific diagnosis. Our office can assist with benefit verification and authorization when scheduling.
When BCBS May Cover Joint Replacement
BlueCross BlueShield coverage for joint replacement is generally based on medical necessity. Coverage may apply when arthritis or joint degeneration causes the following conditions that have not responded to conservative treatment.
Persistent hip or knee joint pain
Loss of joint flexibility or range of motion
Progressive cartilage loss or bone-on-bone degeneration
Conservative treatment without sufficient relief
Difficulty walking, standing, or performing daily activities
What to Expect at Your Consultation
During your first visit, Dr. Avino evaluates your joint through a review of your symptoms and medical history, physical examination, X-ray imaging, and discussion of prior treatments.
This evaluation helps determine whether surgical or non-surgical treatment may be appropriate, and provides the documentation often needed to support insurance coverage.
Robotic Joint Replacement and BCBS Coverage
Dr. Avino performs robotic-assisted hip and knee replacement using Mako technology. BlueCross BlueShield generally covers joint replacement procedures based on medical necessity. However, some insurance carriers do not cover the robotic-assisted portion of your surgery, as they consider it experimental despite supporting clinical evidence. If your insurance does not cover this portion, you will be responsible for that fee prior to your surgery.
Robotic Knee Replacement
For advanced knee arthritis. Mako technology supports personalized planning using a 3D model of the knee joint prior to surgery.
Robotic Hip Replacement
For advanced hip arthritis. Direct anterior approach with Mako robotic technology — many patients go home the same day.
1,000+ Robotic Procedures
Dr. Avino has performed over 1,000 robotic-assisted hip and knee replacements using Mako technology — high-volume experience many BCBS patients consider when choosing a surgeon.
Why BCBS Patients Choose Dr. Avino
Patients with BlueCross BlueShield considering hip or knee replacement often prioritize a surgeon with focused training, high surgical volume, and experience with modern robotic technology.
1,000+ Robotic Joint Replacements
High-volume experience performing robotic-assisted hip and knee replacements — the kind of surgical volume patients with BCBS often seek when choosing their surgeon.
Board-Certified & Fellowship-Trained
Residency at the University of Chicago and fellowship in adult hip and knee reconstruction at Cleveland Clinic.
Focused on Joint Replacement
A practice dedicated to hip and knee replacement — not general orthopedics — so every patient benefits from focused, specialized experience.
BlueCross BlueShield Coverage — Common Questions
Does BlueCross BlueShield cover knee replacement surgery?
Many BlueCross BlueShield plans provide coverage for medically necessary knee replacement surgery when arthritis causes significant cartilage loss, bone-on-bone joint degeneration, or mobility limitations that have not responded to conservative treatment. Coverage details vary by individual plan.
Does BlueCross BlueShield cover hip replacement surgery?
Hip replacement surgery may be covered by BlueCross BlueShield when arthritis leads to significant cartilage loss, persistent pain, and functional limitations that affect daily activity. Your specific coverage depends on your BCBS plan and the medical documentation supporting your diagnosis.
Does BlueCross BlueShield cover robotic joint replacement?
BlueCross BlueShield generally covers joint replacement procedures based on medical necessity rather than the specific technique used. The robotic-assisted approach with Mako technology is Dr. Avino’s standard practice and is not billed as a separate procedure. Coverage is determined by your diagnosis and plan benefits.
Do I need a referral with BlueCross BlueShield?
Referral requirements vary depending on whether your BCBS plan is an HMO or PPO. HMO plans typically require a referral from a primary care physician, while PPO plans generally allow direct access to a surgeon. The office can review your specific plan requirements when you call to schedule.
How do I verify my BlueCross BlueShield coverage before scheduling?
You can call (561) 694-7776 and ask for Dr. Avino’s team. Have your BlueCross BlueShield insurance card available so the office can verify your benefits, confirm network participation, and review any referral or authorization requirements before your appointment.
Schedule a Consultation — BlueCross BlueShield Accepted
If you have BlueCross BlueShield insurance and hip or knee arthritis is affecting your mobility, a consultation with Dr. Avino can help determine whether joint replacement surgery may be appropriate. Our office can assist with benefit verification and referral requirements when scheduling.