Our fast-paced lives in recent years have made it almost difficult for us to pay attention to our health. There are quite a few health problems like blood pressure, diabetes, and orthopedic issues on the rise. This has led to an exponential increase in the sales of medical insurance. One of the most common health problems that people above 30 face are orthopedic issues like arthritis, osteoporosis, knee and spinal disorders, etc. While these orthopedic conditions can be treated, thanks to the advancements in medical technology, the prices of the same are quite high. This leads to the question, “does health insurance cover orthopedic surgery?” Read further to know more.
What is Orthopedic Surgery?
Orthopedic surgery is any surgery that is performed to rectify the deformities or functional impairments of the skeletal system. This includes the spine and the other related ligaments and muscles. Any disorder, injury, or discomfort in the neck, spine, hip, wrist, knee, shoulder, or foot is an orthopedic concern. The surgery is performed on the skeletal and inner muscular layers of the body. This could be for issues that arise out of genetic or acquired disorders, acute injury, or an accident. The most common orthopedic surgeries performed are joint surgery, bone fracture repair, etc.
Are Orthopedic Surgeries Expensive?
Yes, when it comes to orthopedic surgeries, it does not just involve the surgery, but the other costs like pre-hospitalization, consultation, medical tests, etc. While most people get their conditions checked at their preferred hospital, the mention of a surgery definitely calls for a second opinion which will jack up the price even further. Though not all orthopedic surgeries are expensive, financial assistance from an insurer will help you.
Does Health Insurance Cover Orthopedic Surgery?
Insurance policies, in general, are very inclusive and exhaustive. Since orthopedic concerns are one of the most common health issues, it is covered by a general health insurance policy. The policy not just covers the cost of the surgery, but also, all the related expenses. This includes the costs of pre-hospitalisation, nursing, ambulance, consultation, etc.
But, this only holds good based on the scope and sum insured of the policy. Similar to other health insurance, the coverage for orthopedic surgeries also has a waiting period of one year or more, and up to 4 years, in case of a pre-existing condition, depending on the insurer and the type of surgery. During the waiting period, the insured is not allowed to make any health insurance claims, regardless of whether the policy covers the surgery or not.
While health insurance policies provide coverage for orthopedic surgeries, some specifications differ across insurers, in terms of the scope of your policy. So, it is of utmost importance to read and understand the terms and conditions of the policy thoroughly before you sign on the dotted line.