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A Guide to Knee Replacement Surgery Coverage under Health Insurance

The knees are one of the most important parts of an individual’s body. They support the body’s weight and are essential to carry out a variety of movements. It is not surprising then, that if the knees were to suffer damage or be the victim of a disease, an urgent and important solution, such as a knee replacement surgery, would be required.

The cost of getting a knee replacement surgery can be quite heavy. It may differ depending on the intensity of the damage and the kind of surgery being done. Thankfully, there are various health insurance plans in the market that provide coverage for this kind of surgery. Let’s learn more about the same.

An overview of the knee replacement surgery

The most common causes of individuals opting for knee replacement surgery are chronic pain, stiffness, osteoarthritis, and so on. Elderly people are more likely to undergo this surgery, mainly due to their joints and immune systems weakening as a result of ageing.

To determine whether you require the surgery, a number of tests, such as X-rays and MRIs might be carried out. Only when a licensed orthopaedic surgeon has given the go-ahead can this operation be carried out.

The extent of coverage of health insurance plans depends on the kind of surgery being performed. A regular knee replacement surgery involves the bone and the cartilage of the damaged knee being replaced by their artificial counterparts. A partial surgery might involve only certain areas of the knee being replaced. In a bilateral knee replacement surgery, the process is carried out on both knees.

In some cases, a health plan may not cover the surgery or may have limits on the coverage amount. You can consider buying critical illness insurance in such a scenario, especially if you or your loved ones are at risk for such health issues. The benefits of health insurance are multiplied when it is supplemented with a good critical illness insurance plan. *

How does health insurance help during knee replacement surgery? 

A health insurance plan can help you immensely when you or your loved one has to undergo knee replacement surgery, in the following ways:

  • Coverage for the cost of the surgery 

The prosthetics required in the operation are quite expensive and are often imported from foreign countries. This hikes up the price of the surgery quite considerably. With a health plan, you do not have to worry about these costs. *

  • Hospitalisation coverage 

Most health insurance plans cover not only the cost of the surgery but also the charges for the hospital stay, room rent, diagnostic tests, pre- and post-hospitalisation, and so on. *

  • Peace of mind 

When someone is going through such a major surgery, the most important thing their family often wants is peace of mind. They do not want to worry about the lack of finances. A health insurance plan allows this peace of mind to the patient and their family members. *

  • Cashless services 

If you have a cashless health insurance plan, then all you have to do is inform the insurer and fill out the claim form. The insurer then takes care of the expenses themselves. You do not have to arrange for large amounts of cash or wait for reimbursement. *

* Standard T&C Apply

Undergoing a knee replacement surgery can be a life-altering experience. The support of a health insurance plan can help you to a great degree in this process so that you can focus on what is important for you – rest and recovery.

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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