Health Insurance for Knee Replacement Surgery

What is Knee Replacement/Arthroplasty?

A knee replacement surgery involves the replacement of the damaged bone and the cartilage with the required prosthesis or artificial joints. It is important to know the full extent of the damage and the type of replacement you need:

• Total knee replacement involves the whole knee being replaced by prosthetics
• Partial replacement takes place only in the affected area of the knee
• Bilateral knee replacement involves both the knees getting replaced at the same time.

While osteoarthritis is the leading cause of knee surgeries in India, there can be many other reasons why people may experience chronic knee pain which makes knee replacement a necessity in order to restore normal functions in the knee.

Most patients opt for this surgery due to prolonged stiffness and ache in their knees. Other than osteoarthritis, rheumatoid arthritis, ligament tears, and other cartilage defects also cause damage to your knees which eventually needs a replacement.

When do You Need Knee Replacement Surgery?

Knee replacement surgery may become necessary when severe pain and mobility issues persist despite trying non-surgical options like physiotherapy, medication, or lifestyle changes. In fact, the surgery is usually recommended to people suffering a lot of pain and severe dysfunction in one or both of their knees. To determine this, a number of tests like X-rays, MRIs, etc. are done to assess your knee's stability and range of motion.

If the patient has extreme difficulty while walking, getting in or out of seated positions, while taking a flight of stairs then it can indicate the need of knee replacement surgery. In some cases, people may even have knee pain while resting.

An orthopaedic surgeon is the best person to determine your condition depending on your age, activity levels, body weight, and other health factors.

How Much Does a Knee Replacement Surgery Cost?

Your overall health and the place where the surgery takes place determine your expenses. Moreover, pre-existing conditions impacting your knees also influence the cost of the surgery. On an average, knee replacement surgery can cost you around ₹1.5 lakh to ₹6 lakh, as prosthetics are costly and often need to be imported from other countries.

You should consider these additional costs in case of a knee replacement surgery:

• Duration of your stay at the hospital
• Physiotherapy/ physical therapy you may need at the hospital
• Future follow-up appointments
• Additional therapy while recovering at your own home
• Transportation costs
• Additional tests and check up

Keeping these things in mind, you should know how much it will cost you and how much of this will be covered by your insurance policy. Thus, it is highly recommended that you opt for a health insurance policy that covers knee replacement surgery.

Is Knee Replacement Covered Under Health Insurance?

Knee replacement surgery can be costly, making health insurance essential to reduce the financial burden. Thankfully, many health insurance companies include knee replacement in their health plans. However, the extent of coverage varies. Some policies may offer full or partial coverage for the procedure, while a few of them provide additional coverage for knee replacement among critical illness insurance in India.

Why Opt for Health Insurance Cover for a Knee Replacement Surgery?

Knee replacement surgery can be pretty expensive if you have any complications or do not have medical insurance that covers expenses related to this surgery.

Therefore, ensure you purchase a mediclaim policy that covers knee replacement surgery with sufficient sum insured. Here are some more benefits of getting a comprehensive health insurance plan:

• Cashless Treatment Facility: Your hospital bills will be settled directly with your hospital. You simply need to visit a hospital that is a part of the network as stated in your insurance. In fact, with the new “Cashless Everywhere” initiative, you can get cashless treatment facility even at a non-network hospital. However, you may need to schedule your hospitalization beforehand for smooth service.
• Cover for Treatment: A comprehensive mediclaim insurance policy will cover your pre-hospitalization and post-hospitalization costs. This can also include the room charges along with the surgeon's expenses. Your health plan will also take care of your in-patient hospitalization expenses.

To Conclude

Before buying a health insurance cover for knee replacement surgery, you should know about some important facts like the waiting period or increase in your usual premium. While this cover is now being offered by many, some insurance providers only agree to pay half of the total cost of the knee replacement treatment. There may also be a longer waiting period anywhere between 2 to 4 years before you can file for this claim. So make sure you go through all these benefits thoroughly by comparing health insurance policies online on Policybazaar.com, and invest in a suitable medical insurance plan.