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Do Health Insurance Cover Orthopaedic Surgery?

Updated On Jan 16, 2022

They argue that good health equals good fortune. Health has never been a serious concern in our country, owing to factors such as demanding schedules, late hours, rising pollution, food poisoning, and fast-paced lifestyles. While India's total life expectancy has grown as a result of improved medical treatment, the number of diseases impacting the youthful population has also increased in the last decade or so. With the rise in lifestyle-related diseases, having health insurance is more necessary than ever, regardless of age or financial means.

Orthopaedic issues have been on the rise in recent years. Although most treatments are non-invasive, certain severe instances may necessitate surgery. This has also raised concerns about whether orthopaedic surgery is covered by health insurance. They may be rather expensive, and there is also accompanying testing, which is why having health insurance coverage may be a smart option. To know more about the health insurance cover for orthopaedic surgery, read on.

Do Health Insurance Cover Orthopaedic Surgery?

What Is Orthopaedic Surgery?

Orthopaedic surgery is often performed on the hip, shoulders, knee, wrist, and other body parts. The operation itself is conducted on the body's skeletal and underlying muscle layers. It is done to treat difficulties caused by inherited or acquired illnesses, as well as problems caused by an acute injury or accident. The surgery takes into account not only the treatment of the human body's skeletal system, but also linked ligaments, tissues, tendons, and so on. Orthopaedic surgery can be performed openly or via arthroscopy. Orthopaedic procedures that are regularly done include arthroplasty, joint surgery, bone fracture treatment, and many more.

Treatment Expenses In Orthopaedic Surgery

Orthopaedic surgery may be costly, which is why it is critical to research health insurance coverage for it. Not only is there a cost for the operation itself, but also for pre-hospitalization, consultation fees, medical test expenditures, and so on. You may even need to seek a second opinion before proceeding with the procedure, which might add significantly to the overall cost. Furthermore, there are several types of operations that all fall under the umbrella of orthopaedic surgery. However, not all of them are the same price. Overall, orthopaedic surgery can be pricey, necessitating the support of a health insurance provider.

Does Health Insurance Cover Orthopaedic Surgery?

Yes, because orthopaedic surgery is considered a medical procedure, most health insurance carriers cover it. Health insurance coverage often covers not just the surgical costs, but also any connected expenses. Nursing expenses, ambulance fees, and other regular charges are frequently covered by health insurance coverage. Orthopaedic operations may also include surgical implants, which are frequently covered by health insurance programmes.

Health insurance coverage may cover the procedure entirely or partially, depending on the extent of the policy and the amount insured under it. Most health insurance coverage covers orthopaedic surgery, but only after a certain amount of time has passed. During the waiting time, the policyholder cannot make any claims on their health insurance policy, even if it covers the procedure. Depending on the kind of surgery and the insurance company, the waiting period might range from one to two years or more. If the ailment is pre-existing, the waiting time is lengthier and might last up to four years.

Endnotes

Orthopaedic surgery is, in fact, covered by health insurance. However, like with other health insurance plans, the specific extent of the coverage varies depending on the policy and the insurance provider. Always read the terms and conditions of a health insurance policy carefully to understand exactly what it covers and what it will provide for. Having a comprehensive health insurance coverage that covers all issues leads to less stress and financial strain in the event of a medical emergency.

Do read - When Is The Right Time To Purchase A Health Insurance Policy?

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Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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