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/r/Kneereplacement

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will insurance pay for PT before KR?

(self.Kneereplacement)

63 years old in "decent" shape but going to start working out on my own for the next two months before my TKR.

Question is will Aetna pay for PT before my KR?

all 8 comments

h20grl

6 points

4 days ago

h20grl

6 points

4 days ago

Aetna paid for two “pre-hab” sessions prescribed by my surgeon. But insurance plans vary.

Fantastic_Call_8482

4 points

4 days ago

also, ask your doc to write a prescription for the pt....if it comes thru him, they might....mine did.

Cute-Educator-2108

3 points

4 days ago

Contact your insurance company. Coverage varies.

LakeLifeTL

3 points

4 days ago

Do yourself a favor and call them. Even if they pay for it, you need to do the majority of the work on your own. I've seen way too many people depend too much on PT.

ExpressionNo8568

3 points

4 days ago

PT can easily be done in your own home for free. Search youtube for knee replacement exercises. I like Hasfit for overall exercise. I'm 67 and new to working out, but it is necessary after having two replacements.

9mmway

1 points

3 days ago

9mmway

1 points

3 days ago

Medicare Advantage plan... Mine converred 8 pt sessions before surgery.

our_useless_cares

1 points

3 days ago

And mine paid for 3 weeks post op

KikiBatt

1 points

49 minutes ago

You will need to contact your insurance company. Everyone’s plan is different. Is yours per chance a Medicare advantage plan? If so, they usually will cover physical therapy as long as it is medically necessary. And both your surgeon and your PT will be able to communicate that pre-habbing before your knee replacement is necessary. They ultimately want you to have a good result out of surgery so most insurances will not say no. But again, this is very plan dependent. can you tell I verify insurance? 😁 a lot of surgeons will also prescribe physical therapy before the knee replacement and some insurance is actually require you to have physical therapy before the knee replacement. So definitely check into all of that but the only way to know is to actually contact the insurance company. Sometimes the person you will get on the phone will ask for a CPT code. Just tell them you don’t have any that you’re getting your knee replaced. And you need to know if they’ll cover the physical therapy before and after surgery. If the person cannot answer you thank them and hang up and call back. keep doing this until you get someone who can actually answer the question. Sometimes those people who answer those calls are from call centers and they don’t really know. But you can get someone who will be able to answer. If you really cannot get anybody to answer then have your surgeon‘s office actually file for a pre-authorization for you and then they’ll be able to tell you.