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Orthopaedic Surgery: Is It Covered In All Health Insurance Plans?

Published On Oct 04, 2022 10:00 AM By InsuranceDekho

Orthopaedic conditions involving the bones and muscles primarily affect older people. Sadly, these illnesses are now being detected in children as well, perhaps as a result of unhealthy lifestyles. The cost of orthopaedic procedures is typically high. Therefore, it may be difficult for your finances if you don't have an already planned financial alternative. You might be thinking whether  orthopaedic treatments are covered under  health insurance or not. Here are the answers.

Orthopaedic Surgery: Is It Covered In All Health Insurance Plans?

Orthopaedic Treatment: What is it?

The pelvis, knees, ankle, elbow, and other parts of the body of a human being are frequently operated on by orthopaedic treatment. The actual treatment is carried out on the human body's muscles and skeleton layers. It is performed to treat issues that result from severe injuries or accidents in addition to problems caused by inherited or acquired illnesses. The operation takes into consideration not just the treatment of the body of the person's skeletal structure but also anything related to ligaments, tendons, nerves, and other structures. Open procedures or arthroscopies may be used to do orthopaedic surgery. Orthopaedic procedures that are frequently carried out include joint surgery, broken bones treatment, and many others.

Does Health Insurance Include Orthopaedic Surgical Procedures?

Yes. For orthopaedic procedures, many health insurance policies in India offer coverage. Nearly all health insurance policies cover expenditures of hospital admittance, which may include a wide range of expenses such as operating room fees, the price of surgical devices, doctor's fees, rent of the room, nursing fees, anesthesiologist fees, etc. Many health insurance policies would also pay for your outpatient and day care charges, including physiotherapy costs.

If you're covered by a health insurance policy that provides daycare treatment coverage, you can ask your insurance company to pay for your orthopaedic treatment regardless of whether it is a daycare operation. A number of health insurance programmes cover daycare treatments. All you have to do is see if daycare treatments are covered by your insurance policy.

Orthopaedic treatment costs might well be partly or entirely covered by health insurance policies. But, your health insurance plan's rules and regulations will determine just how much compensation you receive. In order to determine whether the expense of the treatment would be paid and up to what level, it is best to contact your healthcare company as quickly as the treatment is confirmed.

Orthopaedic Surgery Waiting Period

The period of waiting is the time after purchasing a health insurance policy during which you are not permitted to file a claim. Orthopaedic surgery's waiting time can range from one to two years. And for people with already existing ailments, this time frame can be considerably lengthier. These rules and restrictions, however, might vary from one insurance to another depending on the policy they provide.

Each of the requirements must, however, be made known at the moment the insurance is purchased. After that, you may file health claims starting on the very first day! So that while the provider takes care of the economical aspects of receiving exceptional care, you can concentrate on getting better.


If orthopaedic disorders are not diagnosed in a timely manner, they may have serious consequences. To address some orthopaedic disorders, you could need treatment. Purchasing a health insurance plan that includes care which is for a day of treatment, in addition to open orthopaedic treatments is the only method to safeguard your hard earned cash from orthopaedic treatment procedures. Before filing a claim, be certain to review the rules and restrictions of your plan. We hope you got the answer to your question through this article.

Also Read: The Best Ways To Renew Your Health Insurance Plan On Time


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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