Young Boy on CrutchesWhen in love, we are said to be weak in the knees. Athletes are sometimes knocked to their knees. When we are afraid it can feel like our knees are knocking together. Every aspect of life seems to involve our knees.

A popular children’s song tells you that the leg bone is connected to the knee bone and the knee bone is connected to the thigh bone, and so on. Indeed, when your knee is hurt, everything else seems out of kilter. In order to correct this problem, it’s going to cost you. This could lead to the question of whether health insurance covers knee surgery.

What are the various types of knee pain?

Your body is made up of hundreds of bones and numerous joints. It may surprise you to know that the knee is the biggest joint in your body. Therefore, it’s no wonder that the knee is one of the most used and generally vulnerable parts of your frame.

There are many conditions and situations that can damage your knee. Arthritis involves cartilage wearing away from the joint. Your knees can also be affected by sports or other strenuous exercise, and sometimes exercise can even cause arthritis. Other times, an old knee injury that you forgot about long ago can manifest itself years later as a current pain.

If you are experiencing pain on the face of your knee, this usually signals a problem with your kneecap. Pain that materializes behind your knee is frequently the result of excess water that can create a cyst. You might also have pain on the side of your knees, where they touch each other, which is called medial meniscus or MCL issues. Additionally, pain on the part of your knee that runs along the outer leg is referred to as lateral meniscus, LCL, or tendonitis problems.

Another important component of your knee is the cartilage. This is what covers the bones in your knees to help protect them from injury and allows your knees to move the way they were intended. Cartilage can also become damaged and cause pain. A simple misstep, awkward turn, or serious fall has the potential to trigger major problems.

Knee pain that happens while you are active, such as walking, is usually caused by trouble in the kneecap. Consequently, if your knee hurts when you are inactive, such as while you are just sitting, this might be arthritis. Other symptoms, like swelling or locking of the knee, is frequently the result of a tear or outside force that causes injury.

Is knee surgery covered by health insurance?

Not all knee surgery is created equal. Different components of the knees combined with various types of operations means there are numerous surgical solutions.

A procedure called arthroscopy allows your surgeon to fix cartilage or ligaments using a tiny camera, performing the surgery with very little cutting or blood loss. You might also be a candidate for partial or full knee replacement. In this instance, all or parts of the knee are removed and substituted with other, more sturdy materials, such as metal or state-of-the-art plastics.

All of these surgical methods can come with a hefty price tag.  Most will cost roughly $10,000 but they can rise to more than $40,000, which is determined by the operation and where you go to have it performed.

As long as your doctor recommends knee surgery as medically necessary, most major insurance companies will cover all or a large portion of the cost. You may still expect to pay hundreds or sometimes thousands of dollars out of your own pocket, depending on your coverage and deductibles.

It is important to note that insurance companies will typically not cover anything that is deemed a pre-existing condition. Therefore, if you recently acquired or changed your health insurance, and then scheduled knee surgery, it might not be covered under a new plan.

How do you know if you need knee surgery?

Since there are so many factors that can go wrong with the knees, everyone will probably experience some form of knee pain in their lifetime. However, it is not necessary to discuss surgery for each little twinge. Several issues are looked at before your doctor will recommend surgery.

For example, if your knee pain is so severe that it prevents you from working or otherwise living a normal life, you should definitely see your physician. Continuous, persistent knee pain might also require surgery.

Pain and swelling are your body’s way of telling you something is wrong with a particular area. You could also suffer from knee instability, where you feel like you cannot handle weight, or knee immobility, where you are unable to bend it properly. These are all good reasons to make a medical appointment.

Your doctor may suggest medications to help manage some types of knee pain, such as arthritis or bursitis.  Often, knee pain can be treated with options other than surgery or prescriptions. You may be directed to lose weight, restrict your knee movements, or perform exercises in water to relieve pressure on your knee joints.