Is Health Insurance Covered For Orthopedic Surgery?
Orthopaedic issues have become some of the most common health issues lately, owing to the increasing work-from-home culture and lack of physical activities due to a sedentary lifestyle. Mild issues can be cured by medication and physiotherapy but for serious concerns, doctors may suggest surgery.
If you are about to undergo orthopaedic surgery, remember that it is covered under medical insurance. A policy that covers not only the cost of surgery but also other expenses like pre-hospitalization, consultation, ambulance, nursing, etc. will be the best health insurance plan for you.
Growing Demand for Orthopedic Surgery
As quoted in a Business Standard news item recently, Indians are found to be 15 times more prone to osteoarthritis compared to the US population. The number of knee replacement surgeries alone has shown a CAGR of 32% in the past 25 years. With better healthcare services and good coverage offered by medical insurance companies, it is estimated that in the coming years, there will be 1.5 million joint replacement surgeries performed annually in India. Joint replacement is just a part of orthopaedics, which covers many types of specialized procedures. These numbers show that there is a growing awareness and huge demand for orthopaedic procedures. Therefore most insurers now cover these procedures.
What is Orthopedic Surgery?
Orthopaedic surgery is performed to correct or cure any issues in the musculoskeletal system of our body. These issues can be chronic arthritis, injuries, disorders, or any conditions of bones, joints, and associated soft tissues. Any discomfort or concern related to the neck, spine, knee, shoulder, wrist, hip, or foot comes in the orthopaedic category. Orthopaedic surgery is one of the most common surgeries these days. It can be performed for several issues like joint reconstruction and replacement, bone fracture, rheumatoid arthritis, knee replacement, sports injury, etc.
What is the Cost of Orthopedic Surgery?
Surgery is often the last resort for any orthopaedic concern. Not all orthopaedic surgeries are expensive but there are a lot more expenses involved than the surgery itself like doctor’s consultation, medical tests, and examinations, physiotherapy, medication, hospital stay, etc. Before going for surgery, people mostly prefer to take a second opinion and be sure that surgery is the only option for them. This adds to the costs and therefore it is recommended to get it covered in your medical insurance if you have any orthopaedic concerns. If you have an existing health insurance plan, do check the coverage it offers for orthopaedic surgery.
Does Health Insurance Cover Orthopedic Surgery?
Most general health insurance companies cover orthopaedic surgery. However, the scope and coverage are different for different companies. So it is very important to understand the terms and conditions of a plan before you buy health insurance. In case you are hospitalized, your insurance plan should cover room rent, surgeon’s fees, ambulance costs, pharmacy bills, operation theatre costs, and any other costs directly related to the surgery.
- Waiting Periods for Orthopaedic Surgery:
Depending on the health insurance company and the type of surgery, there are waiting periods from 1 year up to 4 years, which does not allow the insured to make any claims during this period. However, day-care procedures do not have any waiting period. Also note that, if your orthopaedic issue was diagnosed before buying the health insurance, it is considered a pre-existing disease, and the waiting period for pre-existing disease ranges from 2 to 4 years. So while choosing a health insurance plan keep in mind the waiting period specific to your disease or concern. It is recommended that you invest in health insurance with coverage for orthopaedic surgery early in life so that you get all the benefits when you need them.
Orthopaedic issues are serious and require immediate medical attention. You can not delay surgery or procedure as it hampers your day-to-day life. To be prepared for such a situation and protect your savings, invest in health insurance. The best health insurance plan would be the one that covers orthopaedic surgeries along with day-care procedures. Always check the terms and conditions of your policy before raising a claim.