Is Orthopedic Surgery Covered by Health Insurance?

Health Insurance generally covers Orthopedic surgery. Orthopedic surgery is an essential medical procedure that helps in the necessary treatment of the procedure for the treatment for the joints, bones, and muscles. Various types of orthopedic surgeries namely joint replacements, reconstruction of the ligaments, repair of fractures, joint replacements, and other different needful orthopedic surgeries.

Orthopedic Surgery

Whenever we talk about bones, ligaments, joints, knees, or hips it is cover under the stream of orthopedics. The insurance coverage for the entire surgical treatment ortho related issues like joint injuries, ligament reconstructions, muscles, tendons, etc. the injury can be due to some accident, previous hurt, any form of bone-based disease like arthritis, some acute damage, or even some hereditary issue of the joints, bones or even ligaments, Arthroscopy is the medical name for this surgery. Always consult with an orthopedic doctor in Delhi whether you need the surgery as every person has a different metabolism and the intensity of the injury or disease is different.

The Most Common Orthopedic Surgeries

The most common surgeries performed according to the severity and condition of the various conditions and injuries are as follows: –

● Replacement of the Joints

In this surgery, the affecte joint from arthritis or a damaged joint from some earlier injury is replaced with a prosthetic joint made out of alloy, ceramic, or plastic.

● Repairing of Fracture

Fracture repairing involves the simple re-aligning of broken bones with the help of crews, plates, or rods. It stabilizes the affected area and also helps in further healing ultimately.

● Spinal Fusion

Through this surgery, two or more vertebrae are join together. Usually, bone grafting or implanting is use to stabilize the spine and reduce the pain which is cause due to the degenerate disc or spinal deformity.

● Arthroscopy

This is one of the most minimally invasive surgeries where a camera known as the arthroscope is insert into the joints to understand and diagnose for further treatment of conditions like cartilage damage, ligament torn, and inflamed synovium.

● Hip Replacement

The damage hip joints are replace with prosthetic joints make of metal, ceramic, or plastic. It further helps in healing and better functioning of the hip joints reducing acute pain one goes. This is also known as hip arthroplasty.

●  ACL Reconstruction

Anterior Cruciate Ligament or commonly known as ACL reconstruction is generally done to repair the torn ligament or the ACL of the knee. During the reconstruction, the damage ligament is graft and it is taken from the patient’s own tendon or a donor’s tendon can also be use.

● Repairing of the Meniscus

In the knee, there is a C-shap cartilage which is knew as a meniscus. The repairing of the meniscus helps in repairing the torn meniscus by stitching or suturing, as known medically, the torn edges together.

Health Insurance Coverage for Orthopedic Surgery

Talking about health insurance coverage for all orthopedic surgeries includes all the A to Z costs of the surgery. Of course, the extra expenses like the extra medicines, or if during surgery extra blood is need then that has to be pay by the patient personally. Let us now understand a few essential points about health insurance coverage for all types of orthopedic surgeries:

● The Deductibles Plus the Co-Payments

In health insurance plans, there are two essential parts, the deductibles, and the co-payments. Deductibles are the sum amount of money the insured has agreed to pay towards the cover claimed from the policy for the surgery. And the co-payments are a specific amount that the insurer has to pay during the time of claim.

Essentially Medical Procedures

While talking about essential medical procedures, do check your policy whether it would be covering your surgery. Medical insurance covers treatments like repairing ligaments, joint replacements, fracture surgeries, and other surgeries which would be a treatment for mobility and severe injuries.

● Prior Authorization and Having a Second Opinion

Do check that all your needful medical documents are submitte to the insurance company before the claim. So be in touch with the best hip replacement doctor you are consulting and get all the documents prior to the surgery.


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