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Orthopaedic Surgery Coverage Under Health Insurance
Aug 5, 2022

Coverage for Orthopaedic Surgery Under Medical Insurance

Orthopedic conditions, once limited to elderly individuals, are now commonly observed among people of all ages. The youth is being diagnosed with them, due to their sedentary lifestyle, thereby posing a risk for their joints. This problem has increased even more since the start of the COVID-19 pandemic, which has further worsened the lifestyle of the youth. As organizations have adopted the work-from-home culture, it is an increasing risk being posed, especially to the working strata.

The meaning of orthopedic surgery

Orthopedic surgeries are treatments performed on the musculoskeletal system of the body, due to an injury or other medical conditions like congenital or acquired disorders, chronic arthritis, acute injuries to bones, ligaments, tendons, and other associated tissues. These orthopedic surgeries can either be performed by a process called arthroscopy or even traditionally by open surgery method. While arthroscopy is a daycare procedure, open surgeries require the patient to get admitted to a hospital for a few days. However, in both cases, the treatment cost can be steep, and that’s when medical insurance comes in handy to mitigate the financial burden of the treatment. * Standard T&C Apply

What are the costs incurred on an orthopedic surgery?

Since the treatment of the musculoskeletal system can rack up expenses, it is essential to secure your finances using a health insurance policy. The surgery isn’t the only cost of treatment, but pre/post-hospitalization expenses, consultation fees, any medical tests that may be prescribed, are some other expenses that can be incurred. Sometimes, even a second opinion may be required that further bumps up the treatment costs. Further, based on the type of treatment for different parts, like joint replacement surgery, joint arthroscopy, bone fracture repair, soft tissue repair, spine fusion, and debridement, the treatment costs differ. This treatment can drain you of your hard-earned savings and using a medical insurance plan like an individual cover, health insurance plans for family, group insurance covers, health insurance for senior citizens and the like, can be useful. * Standard T&C Apply

Do health insurance plans offer coverage for orthopedic surgery?

Based on the type of insurance cover, orthopedic surgeries are also covered under the ambit of a health insurance policy. While almost all insurance companies cover hospitalization expenses, what you need to look for is the coverage for pre-treatment costs. Some plans even go on to include the cost of surgical appliances, the cost of implants, doctor’s fee, room rent charges, and other similar costs based on the procedure. After the discharge, in most cases, physiotherapy is recommended for the patients, and that’s when a policy that covers the post-treatment expenses is beneficial. Even if the surgery is arthroscopy, which is a daycare procedure, health insurance plans that provide daycare coverage include its treatments within the policy’s scope. The extent to which a policy covers the treatment cost is based on the terms and conditions of the plan. Thus, you need to familiarize yourself with the fine print if you intend to seek a plan that covers specifically orthopedic treatments. * Standard T&C Apply

Do orthopedic treatments have a waiting period?

Not all orthopedic treatments have a waiting period. Some treatments are covered right after the initial 30-day waiting period. However, in some cases, a waiting period may be mentioned which can be anywhere between 12 months to 24 months. Moreover, you also need to keep in mind that the orthopedic treatment for an already existing ailment may require a longer waiting duration. * Standard T&C Apply So, remember that orthopedic treatments are covered by a Mediclaim policy, and you can take advantage of it in case of an unexpected event or even for a planned medical procedure. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.  

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