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Is Knee Replacement covered in Health Insurance?

  • Author :
  • TATA AIG Team
  • Published on :
  • 30/01/2024
  • 2 min read

Knee replacement is one of the common procedures undertaken by the elderly population for improved quality of life. The number of patients admitted for knee replacement surgeries in India has increased significantly in recent times.

However, there often needs to be more clarity regarding the availability of knee replacement health insurance to help share the burden of this surgery and to reduce out-of-pocket expenses.

Most top insurance providers offer customisable plans for medical insurance to allow flexibility of coverage to everyone. Let us find out whether knee replacement surgery insurance coverage is available in India.

All About a Knee Replacement Surgery?

Before we dive deeper into the question of “Is knee replacement covered by insurance?” Let us understand briefly what a knee replacement surgery is.

Similar to how our bodies witness wear and tear as we age, the different joints within the body are significantly impacted with age as well. The knee joints undergo extensive pressure due to changing habits, sedentary lifestyle, stress, etc.

Due to this, knee pain is inevitable, and knee replacement surgery is commonly recommended. Other cases where knee replacement surgery might be required are ligament tears, arthritis, injuries, etc.

In this surgery, the damaged cartilage and bones are replaced with artificial sub-parts or prosthetics to restore normal knee functions for independent walking and running regularly.

Knee replacement surgeries fall under the orthopaedic category and are very expensive, making health insurance a prime investment tool for financial support.

Cost of Knee Replacement

The costs incurred during a knee replacement surgery are not limited to the operation alone. The other expenses include the following:

  • Hospital stay duration pre and post-surgery

  • Tests and other routine check-ups pre-surgery

  • Transportation costs if an ambulance is required pre and post-surgery

  • Physical therapy costs at the hospital

  • Follow-up expenses for doctor consultations

  • Physiotherapy charges at home

The overall knee replacement cost comes up to be approx ₹2 to ₹3 lakhs minimum. Therefore, finding and purchasing a health insurance plan that extends coverage for knee replacement surgeries can help reduce the cost of personal expenses by a significant margin.

Inclusions of a Knee Replacement in Health Insurance

Most of the top insurance providers today offer coverage for knee replacement surgeries with their health insurance plans. However, the level of coverage can vary from policy to policy.

  • Here is a standard list of inclusions in a knee replacement health insurance plan.

  • Pre-hospitalisation charges, which include room fares, nursing fees, etc.

  • Post-hospitalisation charges.

  • Cash support for shared accommodation (varies from policy to policy).

  • Ambulance charges, if any.

  • Follow-up consultation fees from the authorised doctor.

  • Cashless treatment flexibility wherein the insurance provider provides a list of network hospitals where you can consult and get your knee replacement surgery without having to pay from your pocket.

Conclusion

With the changing environment and unpredictability of new diseases and health issues, investing in a financial safety net like a health insurance plan has become a necessity today to keep up with the increasing healthcare costs worldwide.

Tata AIG’s medical insurance is one of the most effective tools to rely on when in need of urgent financial assistance in times of unforeseen medical emergencies. For knee replacement, the cost of knee replacement surgery with insurance is more economical and allows you to plan your finances better.

Other than knee replacement coverage, some of the other significant benefits of health insurance plans that you can avail with us include a high claim settlement ratio, restoration perks, cover for homoeopathy, ayurvedic or similar treatments, etc.

We take pride in keeping our customers first and thus offer the complete convenience of buying any health insurance plan of your choice directly from our website.

Additionally, we also offer easy comparison tools on our website to help you choose the best one based on specific coverage needs.

FAQS

What is the recovery period for a knee replacement surgery?

After the surgery is completed successfully, the recovery period can be up to 12 to 18 months, depending on the severity of the issue at hand. It is advisable to avoid straining the knees during the recovery period and taking gradual steps to normalisation to avoid unnecessary complications.

What is the minimum waiting period for health insurance for a knee replacement surgery?

For most popular health insurance providers, the waiting period ranges from anywhere between 24 months to 48 months. Thus, it is recommended to understand the different policy terms and conditions in detail and check for the minimum waiting period to get maximum financial support when in need.

Is knee replacement surgery considered to be extremely risky?

Knee replacement surgeries are very common and are not labelled as high-risk because they are non-invasive in nature. However, some familiar risks are always aligned with any medical procedure, which will be explained to you by the doctor.

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Disclaimer / TnC

Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.

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