Health Insurance

Does Health Insurance In India Cover Orthopaedic Surgery?

Orthopaedic surgery is recommended when individuals have issues with their bones, joints and the musculoskeletal system in general. The person may be old or young and the reason for getting the surgery may be different, but the general idea is that if they have the right kind of medical insurance policy, then those procedure costs will be covered. The decision to get the surgery done is huge and can be life changing as it is most often taken when no other option is available. The different parts of the body that get affected normally include the knees, hips, ankles, shoulders, wrists and elbows, though other parts may also be involved when there is major trauma of some kind or if there is some progressive disease that affects the joints and bones over a long period of time. 

Orthopaedic Conditions That Require Surgery

Some commonly performed surgical procedures for orthopaedic conditions include the following- 

  • Joint replacement and reconstruction surgeries
  • Repair of fractures
  • Repair of soft tissues when needed
  • Osteotomy- Deformed bones or extra growths are corrected using this procedure, to help improve alignment. 
  • Spinal fusion surgery
  • Fusion of bones too, when needed is done
  • Joint revision surgery for people who have already had their knee joints replaced when they were younger, as artificial joints do not last forever. They may help you for 10-15 years, but not for longer. 
  • Debridement of wounds

Which Medical Insurance Policy Is Right For You?

Surgery in general is an expensive affair and orthopaedic surgeries are no exception. This is because there is substantial expenditure involved in pre-operative assessments, for the procedure itself and physiotherapy and rehabilitation which needs to be done afterwards. There are many insurance providers who can provide you with tailor made insurance plans. Medical insurance plans these days tend to include most aspects- like pre-procedure assessment costs, diagnostic test costs, doctor fees, operating room fees, anaesthesia fees, nursing charges, PPE, surgical implants that will be used during the procedure and even cover post-operative rehabilitation and physiotherapy. But, not everything is covered. You will need to read the fine print on the policy form very carefully. Additional benefits may also apply in some cases, but it is again contingent on your policy. Recently, medical insurance policies have begun offering coverage for robotic surgeries too, so that is a good thing for you to know, but with set limits. The rest of the fees will be borne by you. 

SBJI is the best orthopaedic hospital in Hyderabad, known for its expertise on orthopaedic surgery, experienced doctors and state-of-the-art infrastructure. We offer the best knee replacement surgery services in Hyderabad and our specialists will be able to diagnose your problem effectively and provide a feasible solution that will help reduce pain for you and allow you to live life better. We partner with insurance companies regularly, so talk to our Claims department for more information.

Frequently Asked Questions

Hospitalisation and surgery can both be very costly and stressful for you to deal with and drain your life savings significantly, in a very short period of time. To prevent that from happening, get a medical insurance policy that will help cover for pre-, procedural and post- surgery charges properly and smoothly and ensure your continued financial security.

Yes, most medical insurance policies cover orthopaedic surgeries too, but conditions do apply.

If you have a traumatic injury, a progressive disease or acute or chronic condition that affects your joints and reduces your quality of life, then you may be recommended surgery. This is especially true if all other methods of pain management have failed.  

If you take a medical insurance policy after your orthopaedic condition has been diagnosed, then you will need to wait for a specific period of time, before you can make a claim for all the expenses that were incurred before, during and after you got the procedure done. This is usually short and is contingent on the type of policy you have taken.

A medical condition that you have had from before you got the medical policy done- an example is if you have diabetes and know that is the case, then when you apply for a medical insurance policy, you will be marked as ‘diabetic’ in the pre-existing condition column. The same principle applies for orthopaedic conditions too.