Health insurance switch right after knee surgery

I have had my knee surgery scheduled for months – it’s coming up soon.  And I just found out that I will be laid off from my job two weeks after my surgery.  My health insurance will end just a few days later.  So, I will be losing my health insurance mid-way through this escapade.  I’m worried about having to pay for everything that happens after the surgery.  It will be hard to wait until I have a new job and can take time away from it to do this.  But should I cancel this surgery and wait until I have a new job and new insurance?  On the other hand, I might as well do this surgery and be laid up while I research new jobs.

Brought to My Knees

Dear Brought to My Knees,

Good news: when your health insurance pays for your surgery, they will also be paying for your follow-up visits.  They will pay one amount for your surgery – called a “global” fee.  It won’t matter that your follow-up visits happen after your health insurance has lapsed.  Your doctors have already been paid for those visits.  Check with your doctor and your plan to find out how many days of follow-up care are included; different insurers have different rules.

You should consider how long it might take to find another job and join another health plan.  You have 60 days to decide whether to continue your former employer’s plan (“COBRA coverage”).  Even if it is expensive, you should seriously consider paying the price to stay on your former employer’s plan.  If you go for 63 days without health insurance (90 days in some situations), then your next health plan can refuse to pay for your existing illnesses for up to 12 months. In your case, your “existing illnesses” would include your knee.

Best of luck with your new knee and search for a new job!


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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.