Need Orthopaedic Surgery? Find Out if Your Medical Insurance Covers It

Posted on: Jul 19, 2022 | | Written by:

Need Orthopaedic Surgery? Find Out if Your Medical Insurance Covers It

Orthopaedic Surgery coverage in Medical Insurance

Our body wouldn’t be the way it is without bones and muscles. They help us stand, run, lie down and do countless other activities. This means, they need to be strong and resistant to minor injuries or bumps. However, life is unpredictable, and you never know when you might face an accident, fall, pull or other mishap. And these can lead to fractures, dislocated bones, sprained muscles, torn ligaments and other problems. Then there are bone related disorders like arthritis that crop up with age. Now, treatment costs for bone or muscle related problems can be on the high side in India. And if they are unexpected, they might drain your savings overnight. This makes it necessary to have a good health insurance plan that covers orthopaedic treatments and surgeries. To know more, read on.

About Orthopaedics

Orthopaedics is that branch of medical science that deals with the bones and muscles in the human body. Any surgery that needs to be done to fix any problem with any muscle or bone in our body can be categorised as an orthopaedic surgery. It can be done to fix any broken bone or torn muscle. It can be done to fix any defect caused by any other injury that improperly healed or to fix any problem that you were born with. In addition, age related medical problems like hip replacement, arthritis, etc. also fall under orthopaedics. Many sports injuries like those caused by torn ligaments or tendons as well as any muscular or associated soft tissue may also need orthopaedic surgeries. In fact, injuries caused by road accidents are a common case where this kind of surgery may be needed.

Common Types of Orthopaedic Surgery

There are different types of surgeries that this department deals with. Some might require you to spend many days in the hospital while others can be done in less than a day and are classified as day care procedures.

• Bone fracture repair is perhaps the most common kind of surgery in this department of medicine. People break bones all the time, and with age, bones tend to become brittle and break easily. Road accidents are perhaps the biggest cause of broken bones though sports injuries are a common cause too.

• Joint replacement surgery is another common kind of orthopaedic procedure. It is usually needed for elderly people whose joints may have started to wear off, causing unbearable arthritic pain.

• Another common procedure is osteotomy, where a bone or joint that has lost its original shape because of some reason, needs to be cut open and given its proper shape. Its location might need correction too.

In addition to these, common orthopaedic procedures may include soft tissue repair, spine fusion, arthroplasty, bone fusion, debridement, or even revision joint surgery to fix any problems with the first procedure.

Health Insurance for Orthopaedic Surgery

Health insurance policies cover most kinds of orthopaedic surgery because they are classified not a cosmetic but as full-fledged medical procedures. Both day care procedures as well as longer duration hospital stays are covered by insurance. In fact, along with the base cost of the surgery itself, an insurance company also covers many other expenses arising because of the surgery and hospital stay. So, you do not need to worry about costs like nursing fee, ambulance charges etc. as the same are covered by the policy. Besides this, if the procedure needs a surgical implant, you do not need to worry about the cost of the same. It will be covered by the policy. Moreover, if the insurance policy comes with additional and add-on benefits like companion benefits, the same will be available subject to compliance with the policy terms and conditions.

Understanding the Waiting Period for Orthopaedic Procedures

Health insurance companies have a concept of waiting period to ensure that they can serve the largest number of consumers and yet maintain a profitable business model. It means that the insurance policy will only start to cover certain ailments after a set time has passed since you purchased the policy. For orthopaedic cases, it is the nature of orthopaedic problem that will determine this waiting period.Accidental injuries that need orthopaedicsurgery are covered immediately. Specific procedures may have a waiting period of one or two years. Most pre-existing conditions, if covered, will have a waiting period of four years or so. All in all, bone and muscle related problems can be very painful and cost a lot to fix.So, if you need to pay for these out of your own pocket, you might have to give away a lot of your hard-earned money. It is better to have proper health insurance instead, as it will not only help you tide over the financial emergency, but also give you peace of mind.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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