Health Insurance for Knee Replacement Surgery | PolicyX
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Health Insurance for Knee Surgery

Knee replacement surgery, or arthroplasty, replaces damaged knee joints with artificial implants, often becoming necessary due to age, injury, or…

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Written by Simran saxena
Published: 12 Aug 2024
Updated: 26 Jul 2026
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IRDAI Licensed

Does Health Insurance Policy Cover Knee Replacement Procedure?

Have you ever thought about what your life would be like without knees? Difficult, right? How would you walk, run, sit, and sleep without them? It is important to protect our knees. However, factors like age, injuries, or diseases such as arthritis can damage parts of the knees.

Do not worry! Medical technology has advanced, and with the help of surgery, you can get your knees replaced for the better. And yes! Your knee replacement surgery is covered by health insurance.

How Does Knee Replacement Surgery Work?

Knee replacement surgery, also known as knee arthroplasty, is a procedure in which the worn-out and damaged parts of your knee joint are replaced with artificial implants.

Here's how it works:

  1. Accessing the Joints

    The surgeon makes an incision around the knees to expose the damaged area after administering anesthesia.
  2. Removing the Damaged Part

    The surgeon carefully removes the worn-out surfaces of the bones forming the knee joint. This includes the lower end of the thigh bone (femur), the upper end of the shin bone (tibia), and sometimes the underside of the kneecap (patella).
  3. Implanting the Prosthesis

    Artificial components made of durable, body-safe materials like metal alloys, high-grade plastic, and sometimes ceramics are implanted to replace the natural joint surface.
  4. Balancing the Joint

    The surgeon meticulously positions the implants to ensure the new joint's proper alignment and smooth movement.
  5. Closing the Incision

    Once the joint is balanced, the surgical site is stitched and stapled closed.

With technological advancements, basic replacement surgery is now often performed using robotic procedures. Robotic knee transplant surgery can lead to less time in surgery, faster recovery, and better results.

What is the Need for Knee Replacement Surgery?

Knee replacement surgery is typically required when an individual:

  • Experiences severe pain in the joints.
  • Experiences stiffness in the knee that limits daily activities like walking, climbing stairs, or getting up from a chair.
  • Experiences pain that persists despite conservative treatments like medications, physical therapy, and injections.
  • An X-ray confirms severe joint damage.

Why Do You Need Health Insurance for Knee Replacement Surgery?

There are several reasons why health insurance can be beneficial if you are planning for knee replacement surgery. Consider the following reasons:

  • Beat High Costs

    A knee replacement surgery can cost between INR 50,000 to INR 1,50,000 for one knee, depending on the procedure, surgeon, and hospital.
  • Covers Hospital Room Rent

    You can claim reimbursement for room rent charges.
  • Covers Surgeon's Fees

    Health insurance covers the charges for your surgeon who performs the surgery.
  • Pre-hospitalization

    The policy covers charges for pre-hospitalization procedures such as blood tests, X-rays, and other diagnostic tests.
  • Post-hospitalization

    Your health insurance policy covers post-hospitalization charges.
  • Reduced Stress

    Having a health insurance policy provides peace of mind during crucial medical procedures, knowing that a significant portion of the cost is covered. This allows you to focus on recovery rather than worrying about medical bills.

Know More About: Health Insurance for Robotic Surgery

Conclusion

Around 10 years ago, knee replacement was sometimes considered cosmetic surgery. However, insurance companies now understand that knee replacements are often necessary due to critical illness. Without this surgery, patients may live with chronic pain for years. The good news is that, as per IRDAI guidelines, health insurance plans now cover the cost of knee replacement surgery. Seize this opportunity to live pain-free. Contact PolicyX to learn more about health insurance plans that cover knee replacement surgery.

Health Insurance Companies Network Hospitals

Aditya Birla
Bajaj Allianz
Bharti Axa
Care Health
Future Generali
HDFC Health
IFFCO Tokio
Manipal Cigna
Niva Bupa
SBI Health
Star Health
Tata AIG
New India
Universal Sompo

Frequently Asked Questions

You need to check for the policy wording of your plan. Or contact your insurance provider for clarification on the coverage details of your plan.
If the surgery is suggested by the doctor then it will be covered in health insurance plans.
Yes, some plans provide coverage for after-therapy knee replacement surgery, especially those health plans that cover physiotherapy.
If you feel uncomfortable in your knees while walking, sitting or standing, then you need to contact your orthopaedic surgeon. They will assess the conditions and suggest treatment accordingly.

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