Apr 23, 2025
According to the American College of Rheumatology, around 790,000 knee replacements take place in the United States each year — and this number is increasing, possibly due to an aging population.
If you are still working, plan to retire in less than two years and need both of your knees replaced, you're going to have a choice to make. You could opt to have your knees replaced while you’re still working, so your employer-provided insurance covers the replacement, or you could wait until retirement.
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The right choice is going to depend on factors including whether you will qualify for Medicare before you need surgery, how comprehensive is your employer-provided coverage, whether you have any paid leave at your job and whether you'd prefer to rehab as a retiree or while you're still on the payroll.
Here's what you should consider to make your decision.
How urgent is the surgery?
The most important consideration when deciding whether to have knee surgery now or later is just how urgently you need the surgery. If you are suffering from significant pain and your doctor thinks you need surgery now, and not in two years, then you'll want to do everything possible to get your operation right away.
Healthline reports that most people who get knee surgery report a significant reduction in pain, with only around 20% continuing to experience low levels of discomfort after the procedure.
If you can alleviate your suffering sooner, then choosing to get the surgery sooner makes good sense — unless there is a compelling reason not to.
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Is your insurance coverage more comprehensive now, or will it be later?
The next big question is whether your employer insurance is going to provide more coverage for knee replacement or whether the coverage will be more comprehensive after retirement.
You should be able to contact your employer insurance company and find out what the out-of-pocket costs will be under their plan. As far as your coverage after retirement, that's going to depend on whether you'll be leaving work at 65, and qualify for Medicare right away, or whether you'll need to get stop-gap coverage if you are retiring before 65.
Generally, employer-provided coverage is better than individual coverage, while Medicare coverage differs depending on whether you have the procedure in the hospital, and it's covered by Part A, or if you have it as an out-patient, and it is covered by Part B. (Part B coverage has larger deductibles and coinsurance costs.)
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You can also buy optional Medicare Advantage or Medigap plans that provide more coverage — but come at an added cost. You should visit Medicare.gov to compare coverage options and see what different policies would pay for when it comes to knee replacement.
Based on research into your employer's plan and your Medicare options, you can decide which insurance will leave you with less out-of-pocket costs.
Do you have paid leave at work?
While full recovery for knee replacement can take around a year, according to the Cleveland Clinic, most people can resume the majority of their activities in about six weeks.
If you get your procedure done while you are still working, this could mean taking off an extended period of time. If you have paid leave, that's not a problem. However, you may prefer to get the surgery while you’re still working so that you have income while you're off.
If you don't have paid leave, though, you'd need to arrange for time off — and you may miss out on income during your recovery.
This may not be the best idea in your last few years of work, when you're trying to shore up your retirement savings. If you'd have to rely on your investments to fund your time off, waiting may be the better bet.
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When would you rather recover?
Finally, you need to decide if you'd rather spend your first months of retirement recovering from a knee replacement or whether you'd rather hit the ground running — with two repaired knees.
All these factors should be considered in order to make the decision that's right for you. You may also want to talk with a financial advisor about the implications to your retirement savings and spending, so you don't make a costly mistake you end up regretting.
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Sarah Li-Cain, AFC is a finance and small business writer with over a decade of experience.
