Knee Replacement Insurance: Coverage, Cost

Insurance for Knee Replacement Surgery in India

The cost of knee replacement surgery is anywhere between 5-6 lakh and the reason for such an high cost of knee implants which are imported from other countries including the charges by hospital and doctor. Most importantly costs are higher in metro cities due to higher taxes.

Although insurance for knee replacement surgery in India is offered by most providers, many people don’t know that claim reimbursement is applicable only after the minimum waiting period which is normally 3 years depending on the insurer, this is why claims are rejected by insurance companies. That is the reason why it is recommended to buy health insurance after you reach the age of 30 years so that critical illnesses are covered when really needed as your grow older.

Although the cost of imported knee implants is less nearly Rs. 80,000-90,000, hospitals/doctors charge more money (more than double) from patients in order to make more profits. Also Indian manufactured implants are not preferred since they don’t last longer and side effects which cause health concerns in the future.

Coverage: The coverage offered by insurance companies for knee replacement surgery varies depending on:

  • Waiting period which is normally greater than 3 years
  • Partial or full coverage offered depending on claim amount, hospital expenses etc.
  • Pre-existing diseases are covered when declared at inception

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