Our objective was to compare the availability of hip and knee arthroplasty to an adult insured by Medicaid and by private insurance. All orthopedic surgeons' offices in a South Florida county were contacted by telephone and presented with a hypothetical patient that needed either a hip or a knee arthroplasty for end stage arthritis. Two scenarios were presented. The hypothetical patient was presented as either having private insurance or Medicaid. 14.3% of all offices contacted offered an appointment to patients with Medicaid coverage for hip and knee arthroplasty, respectively. All offices offered an appointment to patients with private insurance. The mean time until appointment was longer for patients with Medicaid when compared with private insurance. Adults insured with Medicaid currently have limited access to total joint arthroplasty within the studied community.