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Does Medical Insurance cover for Orthopedic Surgery?
Sep 22, 2022

What is Orthopedic Surgery? Is it Covered by Health Insurance?

The orthopedic health concerns in India are growing at a steady pace, with some of them not being limited to elderly individuals. They can now be observed across all ages, which is concerning. A sedentary lifestyle adopted by the working class has fuelled the fire. Furthermore, the COVID-19 pandemic has made it worse, as a certain set of people are still working from their homes, eliminating the mobility usually brought about by way of traveling to work. When it comes to orthopaedic treatments, minor treatments can be managed using prescription medicines, exercise, and physiotherapy treatments. But in certain severe cases, surgery is required for normal activity.

What is Orthopaedic Surgery?

Treatments required to be performed on the musculoskeletal system of the body are called orthopaedic surgeries. They are required due to an injury or other medical conditions, like congenital or acquired disorders, chronic arthritis, acute injuries to bones, ligaments, tendons, and other associated issues. The knee, hip, spine, ankle, wrist, and elbow are some common joints that require orthopaedic treatments. Arthroscopy or open surgery method are two ways of carrying out orthopaedic surgeries. Arthroscopy is a daycare procedure, whereas traditional surgeries require hospitalization for a few days. In either case, the treatment cost is steep, and a health insurance cover can help alleviate its financial burden.

What are the Different Costs Incurred Due to an Orthopaedic Surgery?

The costs associated with orthopaedic surgeries can get high and hence, it is best to be protected using a health insurance cover. The surgery isn’t the only cost of treatment; pre-and post-treatment expenses, consultation fees, cost of medical checkups, and other miscellaneous aspects can also contribute. In some situations, even a second opinion may be required, which further bumps up the treatment expenses. Based on the type of treatment for different joints, the cost differs. Joint replacement surgery, joint arthroscopy, bone fracture repair, soft tissue repair, spine fusion, and debridement, are some of the different treatments performed under orthopaedic surgeries. Without adequate insurance coverage, it can drain you of your hard-earned savings and may even pave the way for a debt trap. To select a suitable insurance coverage, if you have a family history of orthopaedic ailments, it is best to use a health insurance premium calculator. This nifty tool can be used for comparing different policies and knowing about the insurance premiums basis the sum insured. *Standard T&C Apply

Is Orthopaedic Surgery Covered by Health Insurance?

Depending on the type of insurance plan, orthopaedic surgeries are covered by health insurance policies. Most insurers include the hospitalization in the scope. However, pre-and post-treatment coverage is what you need to keep an eye for. Some insurance policies even include compensation for surgical appliances, cost of implants, doctor’s fees, room rent charges, and similar expenses. Since most orthopaedic surgeries recommend physiotherapy sessions after the surgery, it is best to look for a plan that includes such post-treatment costs. Health insurance policies not only cover instances of hospitalization but also arthroscopy, which is a daycare procedure. The extent of coverage of every insurance cover depends on its policy terms. Thus, having an informed knowledge of these terms before making the payment is essential. *Standard T&C Apply Among the various benefits of health insurance plans, coverage for orthopaedic treatments is one of them, and for those seeking coverage, is a blessing. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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