Currently, it would depend on what type of insurance you have if you can get knee replacements. Your private insurance carrier should already have it spelled out for you what they will or won't pay for. The policy tells you what is covered and what isn't covered, what is elective and what isn't elective. Most insurance company's determination is based on the reason for the surgery and what therapies (medications, exercise, knee braces, etc) have been used leading up to a determination by a physician for knee replacement surgery, and even what type of knee replacement surgery your doctor recommends. There are several types of knee replacement surgeries.
If you have government insurance like Medicare in Florida, knee replacement is considered "lower limb prosthesis." Here is a link to current info about Florida Medicare coverage for lower limb prosthesis:
http://www.medicare.gov/coverage/Sea...ew+Results+%3E
Here's the main page to look up your state and coverage with Medicare.
http://www.medicare.gov/coverage/home.asp
The way I understand (which is very little) the new Healthcare Reform Act, it mainly forces everyone to have insurance coverage one way or another. Either privately (self insured or through your employer), through a government subsidized state run insurance pools, Medicare, Medicaid et al, or be fined if you don't.
You have to have insurance. Period. What the insurance covers and how much it pays isn't entirely addressed, yet. They aren't going to start giving you free coverage and cover 100 percent for nothing. The federal government has set up a board (a watchdog group basically) to study what is being covered, costs and so forth and to make recommendations.
From the government website:
http://www.healthreform.gov/about/an...html#consumers
Q: I have a pre-existing condition. How can I get coverage this year?
A: This year, if you have been uninsured for 6 months and have a pre-existing condition, you will gain access to health insurance that was not previously available to you. ..
A new program – known as a high-risk pool – will provide affordable insurance for Americans who are uninsured and have a pre-existing condition. This program will provide temporary protection for people with pre-existing conditions until 2014, when insurance companies can no longer deny you coverage based on your health.
Q: Can I join a pool now to lower my costs?
A: Beginning in 2014, reform will create state-based health insurance exchanges that pool small businesses and their employees, which will spark competition and give you the kind of purchasing power that big businesses enjoy today. The exchange will offer the same types of private insurance choices that the President and Members of Congress will have. Increased purchasing power and competition will make premiums more affordable. The exchange will also reduce administrative costs for your businesses and your employees, enabling them to easily and simply compare the prices, benefits, and quality of health plans.
Q: My insurance company wants to raise my rates. What recourse do I have?
A: For most consumers today, it is hard to figure out how to challenge a rate increase. The new health insurance reform law will create a clear pathway for consumers to hold insurance companies accountable.
In 6 months, all new health plans will be required to have implemented a clear and effective process under which policy holders can appeal coverage determinations and claims. States must also have an external appeals process to ensure a fair and objective review of coverage disputes.
Additionally, millions of dollars in grants will be made available this year to states to help create a health insurance consumer assistance office where consumers can learn how to enroll in a plan or file a complaint. There will also be a new website that will begin operating this year, which will help consumers identify and compare health coverage options. Information will be presented in a standardized, easy-to-understand format to ensure that individuals and families understand their options and purchase the right coverage for their needs.
Finally, new standards for the amount an insurance company must pay out in benefits as opposed to profits and administrative expenses will go into effect in 2011. Insurance companies will be required to give money back to consumers if they do not meet those standards. In addition, requested premium increases will be made publicly available, and in 2014, plans that have arbitrarily raised rates previously may not be able to participate in the new health insurance exchanges.