Total Knee Replacement: Does Your Health Insurance Cover the Surgery Cost?


Total Knee Replacement: Does Your Health Insurance Cover the Surgery Cost?

The knees are the most vital yet complex joints in the body. They demand more attention as you age owing to wear and tear. Additionally, they bear the brunt of a sedentary lifestyle, poor posture, and weight gain issues of people that further impacts our life goals. Chronic knee pain can be due to strenuous activity or a long-term effect of health problems such as osteoarthritis or even injury. Knee replacement surgery might become necessary for an individual to restore normal knee functions. In this surgery, also known as Knee Arthroplasty, damaged bone, and cartilage are replaced with an artificial joint or prosthesis.

Since healthcare costs in India are high, one has to consider the financial aspect before undergoing any medical treatment. With knee replacement surgery cost in India, ranging from 1 lakh to 2 lakh rupees, the best thing to do is to invest in a health insurance plan that covers total knee replacement surgery. Having a health cover will protect you in the hour of need and save you from facing any financial burden.

SO, if you are wondering if knee replacement is covered by insurance, read on to know how Care Health Insurance has got you covered. 

Should you go for a Total Knee Replacement?

Osteoarthritis is one of the leading causes of pain and stiffness in the knee. Besides, there are other conditions such as rheumatoid arthritis, psoriatic arthritis, ligament tear, cartilage defect, bone deformity, trauma, etc. due to which a doctor may recommend a knee replacement.

A knee replacement will certainly enable one to lead a healthier life, but there are risks to consider, like in any other surgery. One should keep a watch out if there are any complications. Also, knowing the right time to go for the surgery is crucial. Doctors may not recommend a total knee replacement if a person is below 50 years. However, they would also consider other factors such as health condition, the severity of pain, etc. to identify if surgery is necessary.

It is better if one decides on whether to go for knee surgery or not after assessing other alternatives to knee replacement like acupuncture, along with physical therapy, medication, weight loss, exercises, etc. 

One should opt for knee surgery after weighing the pros and cons. To understand if surgery is the best option or not at this stage, one should consult an orthopedic surgeon for professional advice. 

Benefits of Health Insurance Cover for Total Knee Replacement

Knee problems can be severe. Successful knee surgery can rid you of all the discomfort and help you lead a quality life once again. To minimise the load on your savings due to the medical treatment, it is advisable to opt for a medical insurance policy. The good news is that several Care Health Insurance Plans have knee replacement surgery covered under mediclaim. The ‘Care Individual Health Plan’ – for instance – is a comprehensive health insurance policy that covers the treatment of Total Knee Replacement.

The surgery costs may vary depending on factors like city and implant used in the surgery. Having a policy with an adequate sum insured will prevent financial difficulties.

The knee replacement insurance coverage include:

Treatment cover: The policy will cover your in-patient hospitalisation costs, including the surgeon’s fee and room charges. A health insurance plan will also cover medical expenses during pre and post hospitalisation. 

Cashless treatment facility: In the cashless treatment facility, we will settle your hospital bills directly with the hospital. All you need to do is select any network hospital empanelled with us and avail cashless treatment. Make sure you inform us 48 hours before your planned hospitalisation. 

Please note the knee replacement waiting period in health insurance is 24 months or 2 years under specified/named ailments. Also, please check for applicable sub-limits on expenses covered and policy terms from the brochure. 

>>Click to read about: cashless medical treatment

Final Thoughts

Having a health insurance policy is a lifeline for every family. It offers vital financial support and helps in achieving one’s health goals without any obstacle. Cover for Total Knee Replacement in Health Insurance is a beneficial feature you must look for when choosing a health policy. Also, remember to keep the following points in mind:   

Specific waiting period: The policy comes with a specific waiting period for certain medical treatments. For knee surgeries and treatments, there is a specific waiting period of 24 months. The policyholder is eligible to get coverage after this waiting period is over. 

Sub-limit: There could be a sub-limit on the coverage for knee treatment, depending on the plan one has chosen. Policyholders should read the policy documents at the time of buying the policy. 

Do not let expensive medical treatment cause any obstruction in your road to recovery. Visit our official website to choose a family floater policy today. We also offer coverage for day care treatments and cashless treatment at over 22900+ cashless healthcare providers. 

Disclaimer: Underwriting of claims for Total Knee Replacement is subject to policy terms and conditions. Please refer to the policy terms and conditions to know more about policy benefits.

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