Health Insurance Cover for Knee Replacement Surgery in India

 

 

Our knee is an important joint in the entire musculoskeletal system. The support and strength of the knee are pivotal for fluid movement and locomotion. However, due to injury or degeneration, this joint loses its strength leading to excruciating pain, which hampers the quality of life. Knee conditions have become common, and knee replacement surgery is a beacon of hope. However, due to the rising cost of knee replacement surgeries, it has become essential to consider health insurance plans offering knee cover. Let us look at health policies covering knee surgery costs in India.

A knee replacement surgery offers us a chance to reclaim an active life and eliminate the pain associated with movement. Especially in the case of older adults, the challenges faced due to eroded knee cartilages significantly impact life and overall well-being. Thus most medical practitioners suggest knee replacement surgery as the ultimate cure. However, the sky-rising knee replacement surgery cost is unaffordable for many people. And even if one could afford the price, it might exhaust their savings.

So, the best thing to do is to look for health insurance plans offering coverage for knee transplant costs. Several health insurance companies allow policyholders to raise claims for knee replacement surgeries. However, some companies in India might cover knee replacement with critical illness insurance. Read on to learn about knee replacement surgery in India, also called arthroplasty, and if it is covered by health insurance.

What is Arthroplasty/Knee Replacement Surgery?


Several factors lead to trouble in the knee joints of people. Ignoring minute issues like pains, falls, etc., in the initial phase of your life might cause you greater trouble later, especially during old age.

If you talk about the factors that cause chronic knee pain, aging, obesity, and an inactive lifestyle are among the common ones. On the other hand, a leading cause of knee surgeries in India is osteoarthritis. Many people face issues like aches or continued stiffness that cause them chronic knee pain, making it inevitable to go for knee replacement to bring normalcy to the knee functions. Further, ligament tears, rheumatoid arthritis, and cartilage defects can also cause knee damage requiring replacement in the long run.

So, what does a knee replacement surgery do? A knee replacement surgery replaces the damaged knee bone or the cartilage, causing trouble. It uses prostheses or artificial joints depending on the damage and the replacement required. For instance,

In total knee replacement surgery, the whole knee is changed, and prosthetics are used as a replacement
In case of partial replacement, only the affected area of the knee is taken into consideration
The process of bilateral knee replacement involves the replacement of both knees together
Buying critical illness insurance coverage helps lower the financial strain caused by this highly expensive medical treatment.

When do you need Knee Replacement Surgery?

Knee replacement surgery is generally recommended for people who experience severe dysfunction or extreme pain in one or both knees. Before starting the treatment, several tests, such as MRIs, X-rays, etc., are performed to assess the problem and its range. Some people find walking, climbing stairs, or getting up from a seated position difficult. These simple activities cause them severe pain. On the other hand, some people may even feel knee pain while in a sitting or resting position.

To know the condition of your knee, you must visit an orthopedic surgeon who can determine if you need a knee replacement surgery depending on different factors such as your age and weight, activity levels performed, as well as other health factors.

How much does a Knee Replacement Surgery cost?

The cost of knee replacement surgery in India depends on several factors, such as the patient’s overall health condition, the city/location where you are located, the hospital (private/government) where you want to get the surgery, etc.

If you are suffering from any other health condition or pre-existing diseases, it might also impact the surgery expense. Generally, the cost of knee replacement surgery for Indian residents can range between INR 1.8 lakhs to 4 lakhs depending on different situations, as mentioned above. Overall, these surgeries are quite expensive as in many cases, the prosthetics used in the surgery are imported from other countries.

Besides the above, one should also consider additional charges such as:

Duration of pre-and post-hospitalization or hospital stay
Physiotherapy required at the hospital after the surgery
Follow-up appointments that are needed
Additional costs during the recovery time at home
Additional tests, etc.
All these things should be considered while considering the expenses and how much of the costs are covered by your insurance policy. Thus, comprehensive health cover for your knee replacement surgery is recommended. Several health insurance companies offer policies covering knee replacement surgery in India (applicable for Indian citizens). Individuals willing to buy a plan must take care of the different costs per their needs and buy the most suitable policy.

Why Opt for Health Insurance Cover for a Knee Replacement Surgery?

Knee replacement surgery is recommended in case of severe knee issues. Individuals suffering from knee conditions and pain can be relieved of the same and lead a pain-free life by performing knee replacement surgery. But looking at the huge expenses and the complexity of the surgery, it is recommended to avail of a medical insurance policy that covers the costs of this treatment. Hence, consider buying a health insurance plan with an adequate sum insured to cover your knee replacement surgery.

1. Cashless treatment:

With a cashless treatment facility, you can get the payment of the hospital bills for knee replacement surgery directly settled by the insurance company. You can avail of this facility by getting your treatment done at a network hospital of your insurer. For smooth cashless treatment, it is recommended to schedule the surgery beforehand and inform your insurer accordingly.

2. Avail maximum cover for treatment:

With a comprehensive health plan, you can get coverage for pre- and post-hospitalization costs, room charges, surgeon’s expenses, in-patient hospitalization, and much more.

To Conclude

Author Bio

Paybima Team

Paybima is an Indian insurance aggregator on a mission to make insurance simple for people. Paybima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. Paybima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.

Choose from India’s top insurers

Latest Post

What consequences does it bring upon the insured if the person offers wrong information on his/her life insurance proposal form? Let us find out in this post!

See nowSee now

There are plenty of life insurance myths that people have regarding  and they need to be dispelled.


It is thanks to these wrong ideas that people fail to see insurance as what it truly is – a vital part of your financial planning. You need to understand that these policies are an important constituent of your financial contingency plan – one that would protect your near and dear ones financially in the future. It would make sure that they do not experience a shortage of funds when they need them in the future. In certain cases, it can also act as a source of income following retirement as well as ailments and accidents that render you unable to work and earn.

See nowSee now

When Rajesh wanted to purchase a new life insurance policy for his family, many of his friends advised him to understand the claim settlement ratio of a company. Although he didn’t understand what claim settlement ratio is, he knew that it was relevant in making the decision to buy a policy from a particular company. He therefore researched about it, compared plans and at last, he bought a policy from a company that had a high claim settlement ratio.

Buying a new online term insurance plan involves researching on various things like cover, exclusions, add-ons, and one should know about them in detail. For example, Tata AIA is a leading insurance company that offers a wide range of insurance plans in market at very competitive prices. However, being competitive in pricing alone is not enough, it is necessary to understand the company’s claim settlement ratio (CSR) before purchasing a plan.

See nowSee now

Saral Jeevan Bima Yojana is a new standardized life insurance policy that has been brought about by the IRDAI (Insurance Regulatory and Development Authority of India) so that people can have an economical life insurance policy.

This is a non-participating and non-linked individual pure risk premium life insurance policy. In this case, your nominee would receive the sum assured if you pass away while you are covered by the policy. In its annexure, the policy states some benefits and riders. Apart from that, it does not offer any other benefit, rider, variant, or option. The only exclusion in the policy is that of suicide.

See nowSee now

The Indian government offers various life insurance plans to secure the financial future of people. The PLI or Postal Life Insurance is one such government policy that monetarily protects the lives of your family members at an economical postal interest.  

See nowSee now