Covering the cost of joint replacement surgery

So you’ve been told you need a hip replacement and, even though you may feel young and healthy, it can be quite a shock to face the reality of such an invasive procedure and the bill which follows.

A hip replacement is a common form of surgery in Australia and most achieve excellent results within a short period of time. The only real surprise about most joint replacement surgeries is the actual cost of the procedure, especially if it’s not covered by your health insurance.

It’s a fact of life that none of us are getting any younger, and with the inevitable ageing process our health and medical needs change with each passing year. And you don’t have to be approaching middle or old age to be in possible need of joint replacement cover.

Joint replacement includes hip (the most common), knee, ankle, wrist, shoulder, elbow joint and spinal disc, so even if you’re young and active there’s a chance that a sporting injury may flare up and need to be quickly dealt with by a specialist.

Health insurance cover varies greatly with coverage for joint replacement – some will cover all of these types of surgery, while others will cover a few or none at all. Gap payments will also vary between insurers. And for those with pre-existing conditions, many health insurers will make you wait a 12-month period before you can claim treatment on private health insurance.

It’s an expensive procedure if you’re not covered and costs can spiral to $24,000 if there are complications. Hip replacements typically can cost between $8,000 and $10,000, if you choose to be treated privately without insurance.

Some policies include the cost of treatment, along with surgery and accommodation costs. Also bear in mind you may need to utilise the services of several doctors including the orthopaedic surgeon who is your main specialist, an assistant surgeon, an anaesthetist, a radiologist, and pathologist. You may also need a physiotherapist and occupational therapist to help with your recovery. Each of these specialists will bill you separately, so it’s important to find out how much of their charges will be covered by private health insurance.

The best thing to do is check your health insurance policy to see whether the levels of cover are adequate for you and then compare the options on a comparison website such as www.comparehealth.com.au to find the best cover at the best price.