Medicare Hip & Knee Replacement — Palm Beach County
Medicare Coverage for Hip & Knee Replacement
Dr. Robert J. Avino is a board-certified, fellowship-trained orthopedic surgeon accepting Medicare for evaluation and treatment of hip arthritis, knee arthritis, and joint degeneration — including robotic-assisted hip and knee replacement using Mako technology.
Medicare Accepted
1,000+ Robotic Procedures
Board Certified & Fellowship Trained
What Medicare Covers for Joint Replacement
Medicare commonly provides coverage for medically necessary hip and knee replacement when arthritis or joint degeneration causes significant pain and functional limitations that have not responded to conservative treatment.
Medicare Part A
Part A is hospital insurance. For joint replacement, it may cover the inpatient hospital stay, operating room, anesthesia, and facility fees when surgery is performed on an inpatient basis.
Medicare Part B
Part B is medical insurance. It may cover surgeon fees, office visits, pre-surgical evaluations, diagnostic imaging such as X-rays, and outpatient follow-up care after joint replacement.
Medicare Advantage
Medicare Advantage (Part C) plans through carriers such as Aetna, UnitedHealthcare, and Humana may also cover joint replacement. Benefits and cost-sharing vary by plan — calling the office to verify coverage is recommended.
Coverage details — including deductibles, coinsurance, and authorization requirements — vary by individual Medicare plan. The office can assist with benefit verification when scheduling.
When Medicare May Cover Joint Replacement
Medicare 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.
Severe hip or knee joint pain
Significant loss of mobility or function
Advanced cartilage loss or bone-on-bone degeneration
Conservative treatment without sufficient relief
Reduced ability to perform 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 whether your condition may meet Medicare’s criteria for coverage.
Robotic Joint Replacement and Medicare Coverage
Dr. Avino performs robotic-assisted hip and knee replacement using Mako technology. Medicare 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 Medicare patients consider when choosing a surgeon.
Why Medicare Patients Choose Dr. Avino
Patients with Medicare who are 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 Medicare patients 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.
Medicare Coverage — Common Questions
Does Medicare cover knee replacement surgery?
Medicare commonly provides coverage for medically necessary knee replacement surgery when arthritis leads to significant joint degeneration, bone-on-bone contact, or loss of mobility that has not responded to conservative treatment. Coverage details may vary depending on your specific Medicare plan and any supplemental insurance.
Does Medicare cover hip replacement surgery?
Hip replacement surgery is often covered by Medicare when advanced arthritis causes persistent pain, reduced mobility, and loss of joint function. Your specific coverage depends on your Medicare plan, supplemental insurance, and the medical documentation supporting your diagnosis.
Does Medicare cover robotic joint replacement?
Medicare 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 Medicare?
Traditional Medicare (Parts A and B) generally does not require a referral to see a surgeon. Some Medicare Advantage plans may require a referral or prior authorization depending on your specific plan. The office can review any referral or authorization requirements when you call to schedule.
How do I verify my Medicare coverage before scheduling?
You can call (561) 694-7776 and ask for Dr. Avino’s team. Have your Medicare card or Medicare Advantage plan 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 — Medicare Accepted
If you have Medicare 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.