Medicare Frequently Asked Questions

Here are the questions that people frequently ask us. If your question is not listed below, you need further information, or you have special circumstances, please call our office at 954-489-4575. We want to hear from you.

Q: Why should I have surgery with Dr. Leone?

A: Dr. Leone has earned a reputation over his extensive career as one of the nation’s top orthopedic surgeons for solving a variety of hip and knee issues that other physicians often choose not to treat. As head of the Leone Center for Orthopedic Care, he has been instrumental in building the stature of Holy Cross Hospital as a nationally recognized leader in patient care. His outstanding reputation among his peers in the medical community and the numerous referrals of new patients he receives from those he has treated in the past are a testament to his extraordinary skill and his entire team’s commitment to exceeding patient expectations.

Q: Does Dr. Leone accept insurance? 

A: Dr. Leone is part of the Holy Cross Medical Group and will accept all insurance plans that the Medical Group accepts. Please feel call our office to see if a particular insurance plan is accepted.

Q: Does Dr. Leone take care of patients with Medicare insurance?

A: Absolutely. Dr. Leone welcomes and cares for many patients who are Medicare beneficiaries. In fact, patients with Medicare coverage make up a large portion of Dr. Leone’s practice. Although they are required to pay a fee for Dr. Leone’s services, all other expenses associated with their care is covered by their Medicare and their supplemental insurance. If a patient has a secondary insurance, they may be able to submit to their secondary insurance for reimbursement and depending on their specific plan, they may get reimbursed.

Q: I have Medicare insurance. If I choose Dr. Leone as my surgeon, what does Medicare pay for?

A: Many services associated with hip or knee replacement are covered by Medicare, including hospitalization at Holy Cross Hospital, prosthetic costs, anesthesia, first assistant, radiology, physical therapy, home health services and supplies. All of these services will be billed directly to Medicare. It is only Dr. Leone’s service fee(s) that will not be covered by Medicare. His services are available to Medicare beneficiaries only under a private pay arrangement and will be billed to patients directly as a fee for service. This includes a consultation fee and, if surgery is required, a separate surgical fee.

Q: Why would someone want to see Dr. Leone when they must pay a fee for his services when they can get care from other physicians that do not charge a separate fee?

A: Choosing a surgeon is a very personal decision, and certainly cost is a consideration. In our experience, patients choose Dr. Leone because they believe it gives them the best chance of getting the best result and having the best experience.

Q: What is the cost of the initial consultation?

A: First-time Medicare patients are charged $250 for a consultation which includes a thorough history and physical exam. X-rays taken during the initial consultation are billed to Medicare. Existing or former patients of Dr. Leone are charged $150 for the consultation. If surgery is required and is performed by Dr. Leone, the consultation fee will be deducted from the surgical fee.

Q: What is Dr. Leone’s out-of-pocket surgical fee for Medicare patients?

A: Dr. Leone’s surgical fee is determined on a case-by-case basis, after the initial consultation. The average surgical fee for a total hip or knee replacement is $6,000. It may be higher for complex or revision cases. Post-op follow-up office visits for 90 days after surgery are included in the surgical fee.

Q: Why do I need to pay a fee for Dr. Leone’s services?

A: This is a personal decision about who you want to take care of you and how comfortable you feel with the surgeon. With Dr. Leone’s patient-focused, concierge model, he and his team are able to provide each patient with an exceptional level of attentive, compassionate and personalized care. Our goal is to provide the absolute best medical care while making each patient’s entire experience as pleasant, anxiety-free and comfortable as possible while achieving the most optimal result.

Q: What are the options for Medicare patients while in the hospital?

A: Medicare patients can opt for a private room with gourmet meals and other services, at an additional cost to be paid to the hospital. Our staff will be happy to review amenities with you.

Q: When is the payment due for surgery?

A: Payment is due prior to surgery. The Leone Center Patient Liaison is available to discuss payment options with you.

 

We thank you for your readership. If you would like a personal consultation, please contact our office at 954-489-4575 or by email at LeoneCenter@Holy-cross.com.