Is Knee Replacement Surgery right for you?

• Written by Ritika Malik

  Reviewed by Munmi Sharma

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The knees are the most vital yet complex joints in the body. They demand more attention as you age, owing to wear and tear. Chronic knee pain can occur due to a sedentary lifestyle, poor posture, weight gain issues, strenuous activity or a long-term effect of health problems such as arthritis, osteoarthritis or even injury. Knee replacement surgery, also known as knee arthroplasty, might become necessary for an individual to restore normal knee function.

It is a life-altering surgical procedure for people suffering from severe knee pain and restricted mobility. Research shows knee replacement lasts over ten years in 90% of cases and twenty years in 80%. Unfortunately, the exorbitant cost of knee replacement surgery usually prevents many patients from considering timely treatment. This is where health insurance for knee replacement comes to the rescue, benefiting most patients and minimising their financial stress.

In this blog, let’s understand knee replacement, its benefits, its coverage, etc., for your healthcare needs.

What is Knee Replacement Surgery?

A knee replacement surgery is a procedure carried out to replace worn-out or injured knee parts. An artificial joint made of plastic or metal is implanted in the knee area. The method also involves replacing damaged cartilage and bones. Doctors recommend this procedure for people with acute knee pain or knee-joint-related conditions.

Knee Replacement Surgery Types

Surgeons perform knee replacement surgery in two different methods, which are:

• Total Knee Replacement Surgery: A surgeon replaces all three knee joint areas involving the medial, lateral, and patellofemoral. In most cases, this surgical procedure is performed.
• Partial Knee Replacement Surgery: In this type of surgery, the surgeon only replaces one or two damaged areas. It is often performed on young adults due to knee injury or trauma.

What are the Benefits of Knee Replacement Surgery?

Knee replacement surgery has high success rates when treating knee-joint-related conditions, as it is one of the advanced techniques. It not only enables the patient to lead a healthy life after recovery, but also offers many other benefits like:

• Improved quality of life
• Long-term pain relief
• Regain joint mobility
• Shorter hospital stay

How Do You Identify the Cost of Knee Replacement Surgery?

In most private hospitals, knee replacement surgery costs around INR 1- 3 lakh. However, this cost might increase due to extra services, post-operative care, and recovery. The cost of surgery depends on many factors, like:

• Hospital Type: The type of chosen hospital, such as a government or private hospital, plays a crucial role when it comes to finances.
• Location: Depending on the area, the knee replacement surgery cost might depend on whether it is urban or rural.
• Surgery Type: It involves the type of surgery performed, such as total or partial knee replacement.
• Implant Choice: Involves what implant material is used, basic or premium.

Does Your Health Insurance Cover Knee Replacement Costs?

Most health insurance policies offer knee replacement coverage, which involves specific terms or conditions. Recognising the particulars of the policy is critical to guaranteeing maximum coverage.

Coverage Types offered:

• Hospitalisation Expenses: Involves surgery costs, nurse charges, and room rent.
• Pre- and Post-Hospitalisation costs include consultations, medications, and diagnostic tests incurred before and after hospitalisation.
• Prosthetic Implant Costs: Most health insurance policies offer knee replacement coverage for the implant involved during the procedure.

Why is Knee Replacement Coverage Important?

Knee replacement surgery cost coverage is crucial as it helps:

• Reduces Financial Strain: Covers a substantial amount of the heavy surgery expenses, reducing the financial burden for many people who delay the treatment.
• Promotes Timely Treatment: Patients postponing the treatment due to expenses can prioritise their health without getting apprehensive about costs.
• Comprehensive Care: Covers other associated services such as physiotherapy and rehabilitation.

How to Identify if Your Policy Covers Knee Replacement Surgery?

It is essential to know that not all insurance services cover knee replacement surgery in health insurance. So, specific ways can help you understand whether your policy covers knee replacement surgery:

• Read policy documents thoroughly and inspect exclusions or inclusions in the policy.
• Contact the insurer if some specific terms are unclear, and ensure you understand all the terms mentioned in the policy.
• Some policies involve caps on the reimbursed amount for knee arthroscopy, so look for sub-limits.
• Remember to identify the waiting period for knee replacement, as specific policies have authorised waiting periods before claiming for pre-existing conditions.

How to Apply for Knee Replacement Insurance Coverage?

If you are planning for knee replacement surgery and intend to apply for insurance coverage, follow these steps:

• Select the Reliable Insurer: Pick an insurer like Care Health Insurance offering plans that cover knee replacement surgery.
• Consult an Insurance Specialist: Consult an expert to clear doubts and choose add-ons for increased benefits.
• Submit Documents: To ensure pre-authorisation, submit all the medical particulars, such as reports, suggestions, and cost estimates for the surgery.

>> Also Read: Total Knee Replacement: Does Your Health Insurance Cover the Surgery Cost

Tips to Enhance Your Knee Replacement Benefits

• Familiarise yourself with the terms and conditions before claiming knee replacement insurance to avoid surprises.
• Pick network hospitals to avail of cashless benefits.
• Always be ready with the prescriptions, consultation documents, bill, and other medical records to ensure a smooth claiming process.
• Think of upgrading the policy if the current policy doesn’t cover knee replacement or lacks enough coverage.

Step Into a Healthier Future with Confidence!!

Knee replacement surgery is a blessing for your health, and the trusted insurance can make this transformative procedure inexpensive and stress-free. A comprehensive health policy guarantees restoring mobility and enhancing quality of life. Understanding the policy and preparing for what comes next not only assists in managing expenses but also ensures what truly matters: renewed mobility and your recovery. So, don’t let financial apprehensions hold you back from securing your health; just choose well and get covered.

Disclaimer: The above information is for reference purposes only. Kindly consult your general physician for verified medical advice. The health insurance benefits are subject to policy terms and conditions. Refer to your policy documents for more information.