Are Orthopaedic Surgeries For Osteoarthritis Covered?

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Yes, leading health insurance providers in India cover orthopaedic surgeries for osteoarthritis, such as knee and hip replacement, under specific healthcare plans. Coverage usually requires a 2 to 3-year waiting period for pre-existing diseases, covers hospitalisation, surgical implants and surgery expenses. The majority of health plans pay for hospitalisation expenses, which include costs of operating theatre, doctor visits, room rent, nursing care, and anaesthetists' costs. Pre- & post-hospitalisation charges, including physiotherapy expenses, are generally covered by health plans.


Healthcare Coverage Details



  • Covered Surgeries:Knee replacement, hip replacement, and other orthopaedic surgeries deemed medically necessary.

  • Waiting Period: Policyholders need to complete a waiting period of 24 months or more for specific procedures and treating pre-existing conditions.

  • In-patient hospitalisation:Room rent, nursing charges, ICU.

  • Surgery Costs: Surgeon charges, anaesthesia, operating theatre fees, and surgical appliances.

  • Pre- and Post-hospitalisation:Diagnostic tests, consultations, and physiotherapy.


Important Considerations



  • Pre-existing Condition:If you were diagnosed with arthritis when buying a health policy, it is considered a pre-existing disease and will have a 3-4 year waiting period.

  • Cashless Facilities: Available across an extensive network of hospitals.


So, many health insurance policies offer coverage for orthopaedic surgeries, but you should double-check your policy details to avoid confusion during an emergency. However, health insurance plans may cover the cost of orthopaedic surgery, depending on the specifics of your healthcare coverage. Hence, to evaluate the extent and scope of coverage, it is wise to contact your insurer as soon as the procedure is planned. This will prevent surprises when you need medical care.


Multiple health insurance plans in India cover orthopaedic surgery. With this coverage, you can avoid depletion of your lifelong savings when you have a medical emergency. However, the extent of coverage provided is based on your policy’s terms and conditions. This is why you should find out about the specifics by contacting your insurance provider, which ultimately ensures the financial support necessary for your orthopaedic surgery.