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NC State Health Plan »   Employee Benefits »   Joint Replacement Program

Joint Replacement Program

The State Health Plan is working with select high-quality orthopedic specialists to offer a joint replacement program for eligible employees in need of knee, hip or shoulder replacement surgery. The program simplifies the entire process – from pre-surgery consults and testing, to post-surgery follow-up and physical therapy, with one simple payment. 

The costs and services related to the joint replacement surgery will be billed together eliminating the hassles of multiple billing statements, which is often referred to as a bundled payment.

If member is deemed eligible for the program, by one of the participating providers below, they may be eligible for a single copay instead having their deductible and coinsurance applied to their surgery! 

If a member is eligible, there will be no deductible or coinsurance applied to bundled services. Instead, a member will only be responsible for paying a copay.

  • 80/20 Plan – Member only pays a $600.00 copay
  • 70/30 Plan – Member only pays a $900.00 copay

The bundled payment includes the cost of the following medical charges:

  • Orthopedic surgeon visits
  • Hospital or surgical facility care
  • Anesthesia 
  • Physical Therapy visits
  • Emergency Room visits related to your surgery

The following providers have agreed to coordinate care and billing related to a total knee, hip or shoulder replacement: 

Provider Name

Joint Replacement Procedures

Contact Information

Surgical Center of Greensboro

knee, hip and shoulder replacement

https://surgicalcenterofgreensboro.com/

OrthoCarolina

knee and hip replacement

https://www.orthocarolina.com/

EmergeOrtho PA

knee and hip replacement

https://emergeortho.com/

Surgical Center of Pinehurst

knee, hip and shoulder replacement

https://www.pinehurstsurgical.com/

Raleigh Bone and Joint

knee replacement

https://raleighboneandjoint.com/

Check with the provider to confirm that you are eligible for a bundled procedure as restrictions may apply.

Employee Benefits

  • 70/30 PPO Plan for Employees
  • 80/20 PPO Plan for Employees
  • High Deductible Health Plan
  • Subrogation and Recovery
  • Understanding Disability
  • Important Forms
  • Joint Replacement Program

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https://www.shpnc.org/employee-benefits/joint-replacement-program