Health Insurance

Best Health Insurance Plan For Knee Surgery

Nov 28, 2021

Health Insurance Plan For Knee Surgery

There are many health problems that show up with age or after a serious injury. One such problem is a painful knee. Knee problems affect a large number of people in India. At a recent medical conference held in Pune, surgeons from across the country spoke about how Indians in the age bracket of 45 and 64 years are very likely to require knee surgeries owing to various knee problems. It was also stated that among all the joint problems, knee problems make up close to 70% of the cases. This leads to many people undergoing knee replacement surgeries each year. This also establishes the need for a good health insurance plan to ensure the patient is able to afford the surgery in the best hospital and make a full recovery.

What is a knee replacement? 

Knee replacement is a surgery done to replace the parts of the bone and cap of the knee that get damaged by arthritis or due to some other injury. Metal or/and plastic pieces are inserted into the joint to replace the natural components of the body that degenerate or get damaged with time. The surgery makes it possible for the person to use his knee more easily and in a painless manner. A lot of research and development has gone into the area of knee replacement surgeries and as a result, the facility is widely offered across hospitals in India. 

Cost for knee replacement surgery in India

 

According to a report by the Hindu, the average knee replacement surgery costs INR 1.5 lakhs to INR 2.3 lakhs, inclusive of the entire package treatment expenses. However, now with the cap on knee replacement charges, the overall cost has reduced and the treatment has become quite affordable. 

Why is health insurance important for Knee Surgery? 

Even though knee replacement surgeries are very common these days, the surgery costs a lot of money. This is why it is important to have a good health insurance plan to cover the costs. Many of the family floater health plans and also the individual comprehensive health plans have provisions for such surgeries. But you must remember a few things here:

  1. Waiting period - 
    While many comprehensive health plans, both floater and individual, offer coverage for knee replacement surgeries, there is usually a long waiting period associated with them. These periods range between 2 to 4 years. So do not expect to get the surgery done as soon as you buy the plan. It is thus recommended for you to buy a good health insurance plan well in advance so that later on when there is a requirement, you can effectively and easily make the health insurance claim.

     
  2. Reason for knee surgery - 
    Knee replacement surgeries can happen due to prolonged physical conditions such as arthritis. Or, they can take place because the patient’s knee got damaged due to an accident or injury. In the case of the former, the policyholder will have to follow the waiting period clause. However, for the latter, the claim will be paid immediately. For example, if your knee is broken after a bike accident, your insurance provider will pay the claim even if you recently bought the policy. 

Group health insurance plans also offer coverage for knee replacement surgeries. If you have a good group health plan that offers this benefit, you can surely make use of it while you are still employed. Remember, you will lose your coverage overnight if you leave the job or retire. So if you are planning to get the surgery done and expect the group plan to pay for it, time the surgery properly to receive the insurance benefits sufficiently.

Plans that offer knee replacement covers

While many plans offer this coverage, here are a couple of  plans that are very popular in India currently:

iHealth Insurance Plan from ICICI Lombard 

The iHealth Insurance Plan from ICICI Lombard is one of the most prefered health insurance plans for people who require knee replacement surgeries. Knee replacement is just one of the covers available under this comprehensive health insurance plan that can be bought on an individual as well as a floater basis. The plan has provisions for knee replacement surgeries but after a waiting period of 2 years. The maximum sum insured allowed for knee replacement is a sum of INR 90,000.

Bajaj Allianz Surgical Protection plan

The Bajaj Allianz Surgical Protection plan is another excellent option available to those looking for a good health insurance cover for knee replacement surgeries. It has some excellent features such as a high sum insured of up INR 10 lakhs. People aged 45 years or less do not need to get a pre-policy medical screening done. Apart from knee replacements, the plan also covers a wide range of other surgeries that prove to be very helpful. The plan is available for the entire family. 

TATA AIG MediCare Health Insurance

Known for offering simplified and easy-to-understand health insurance plans, TATA AIG MediCare Health Insurance offers you a comprehensive cover, which includes Joint Replacement Surgeries. However, this treatment comes under the category of Specified Diseases/ Procedure and there is a waiting period of 24 months of continuous coverage.

HDFC Ergo my:health Suraksha Plan

With this plan from HDFC Ergo, you get to select a sum insured ranging from INR 3 lakhs to INR 75 lakhs. The ‘any age entry’ makes the plan a great option. Surgical procedures like knee replacement surgeries have a 24 month waiting period.  Along with this, the plan also offers other benefits such as room rent capping, policy discounts, loyalty discounts etc.

 

Aditya Birla Activ Assure Policy

Aditya Birla Activ Assure Policy is available on a family floater as well as an individual basis. Under the Activ Assure Policy, you get coverage for in-hospitalisation expenses, pre as well as post hospitalisation expenses and many other benefits. The expenses incurred on a joint replacement surgery such as a knee replacement are covered only after 24 months of break-free coverage after the date of inception policy.

In a nutshell

To put it in a nutshell, getting health insurance for a knee replacement surgery is a very important thing to do. You must take care of and protect your health and also your finances. Once you have a knee replacement cover, you can seek the treatment needed and get back on the road to recovery. As you saw, knee problems are very common among Indians, so buy a health cover in advance and keep your future health secured.

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