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Best Health Insurance For Knee Replacement

Name: Best Health Insurance For Knee Replacement
Creator: Savvy
Published: 2023-03-28T10:39:43+10:30

Compare quotes for health insurance that include cover for knee replacement with Savvy.

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Written by , updated on July 6th, 2023

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If you’re tired of putting up with constant knee pain, you may be considering surgery to fix your injury permanently. Knee replacement surgery is a procedure which can return quality of life to someone suffering from ongoing discomfort. However, the best surgeries in this area are expensive and public health waiting lists can be very long. As such, you can opt to use private health insurance to fund your knee replacement.

You can compare private health insurance policies that include cover for joint replacement through Savvy. You can get instant quotes for health insurance to compare from a panel including some of Australia’s leading insurers, so get started with us today.

What type of health insurance offers the best cover for knee replacement surgery?

Medicare can cover all of the costs of a knee or joint replacement. However, a report from the Australian Institute of Health and Welfare indicated that in 2021/2022, almost 30% of public patients waited more than 365 days for their knee replacement surgery, with the average wait time being over 200 days. Because of these long waiting times, many people turn to private health insurance to assist with the cost of getting their knee replacement surgery carried out in a private hospital.

Gold hospital cover is the only tier of private health insurance which must provide cover for joint replacements under Australian health insurance legislation. However, some funds may offer this type of cover with silver plus policies too. For this reason, it’s well worth comparing health cover policies through Savvy to help find an affordable offer which may provide you with the coverage you need for your joint replacement surgery.

How do I compare the best health insurance policies with knee replacement?

These are some of the aspects to compare when looking at different health insurance policies which provide cover for knee replacement, including:

Cost – comparing a range of offers will help you determine which is the most affordable while affording suitable cover for knee replacement
Excess and co-payments – how much will you have to pay as an excess if you do make a claim on your policy?
Inclusions and exclusions – check the documentation that comes with your policy so you know exactly what is and isn’t included
Waiting periods – make sure you’re aware of the waiting periods that apply before buying a policy
Special offers – some funds offer ambulance cover as a standard addition with gold hospital cover policies, but other special offers are sometimes available too, so it’s worth checking these out when comparing policies.

Types of health insurance

Hospital cover

This can help you pay for medical treatment if you need to be admitted to hospital. It can help cover the cost of your admission or accommodation and the fees charged by doctors, surgeons and anaesthetists. It can also cover other costs associated with a stay in a private hospital.

Extras cover

This helps cover the costs of health care treatments outside a hospital setting which aren’t covered by Medicare. This can include major and minor dental treatment, orthodontics, hearing aids, physiotherapy, glasses, contact lenses and podiatry (in most cases with annual limits).

Cover for singles

This is a standard health insurance policy designed for a single person, rather than being tailored to cater to the needs of a couple or family. It may include hospital cover plus extras, or either of these types of insurance on their own, depending on what you're after for your health cover.

Cover for families

A family health insurance policy is designed for a family unit including dependent children who may reach up to 31 years of age with some insurers. It offers private health insurance suitable for the whole family and may include shared limits for all members included in your policy.

Cover for seniors

A health insurance policy aimed at seniors is designed to appeal to people who are in the second half of their life. These are often specific Silver Plus policies that offer the same cover as other health insurance policies, with the exception that pregnancy and childbirth cover may not be included.

OVHC

Visitors who are in Australia on a temporary basis for travel, work or study may be able to take out Overseas Visitors Health Cover (OVHC). Many visas issued in Australia come with a requirement to take out this type of insurance, which covers visitors who may not be covered by Medicare.

Ambulance cover

Ambulance cover is generally available either packaged into your private health insurance or on its own as a separate policy or subscription. By having this protection, you could be covered for all eligible ambulance travel in Australia (subject to your insurer's terms and conditions).

Basic hospital cover

The cheapest and most barebones form of private hospital insurance, this can include cover for rehab, in-hospital psychiatric services and palliative care. Having this policy will enable you to avoid paying the Medicare Levy Surcharge (MLS) and Lifetime Health Cover (LHC) loading.

Bronze hospital cover

Bronze hospital cover is a step up from basic insurance, including 18 further clinical categories such as ear, nose and throat, bone, joint and muscle, digestive system, joint reconstructions, gynaecology and chemotherapy, radiotherapy and immunotherapy for cancer.

Silver hospital cover

Silver hospital cover is the second-most expensive type of policy and offers the second-most clinical categories. On top of what's offered by basic and bronze cover, it also includes heart and vascular system, lung and chest, blood, hearing device implantation and dental surgery.

Gold hospital cover

The highest level of private hospital insurance available in Australia, gold policies can offer cover for pregnancy and birth, weight loss surgery, assisted reproductive services and insulin pumps on top of all the categories provided by silver, bronze and basic hospital insurance.

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Frequently asked questions about health insurance for knee replacements

How much does it cost to get a knee replacement in Australia?

The cost of a knee replacement can be in the region of $15,000 to $20,000 (correct as of March 2023). However, a large portion of this cost may be covered by Medicare as long as your treatment falls within Medicare guidelines. Additionally, if you have gold hospital cover, your out-of-pocket expenses may be no more than a few hundred dollars, depending on how much your surgeon charges to carry out the surgery.

How much quicker can I get my knee replacement done if I have private health insurance?

Under Medicare guidelines, this will depend on the urgency that your doctor places on your need for a knee replacement and the private hospital facilities and expertise available in your local area. In our large capital cities, there tend to be more specialist orthopaedic surgeons and private hospital beds available than there are in more remote or regional areas of Australia. However, your wait may be a matter of weeks, rather than the months it may take if you join a public hospital waiting list.

Will private health insurance cover all the expenses for my knee replacement?

No – you may still have some out-of-pocket expenses, such as paying the excess on your hospital cover policy and possibly a co-payment for each night you spend in hospital. However, these may not always be charged by health insurers. There may also be additional gap payments charged by your surgeon which may not be covered by your private health insurance.

What is the average waiting time to be able to claim for a knee replacement?

Under Australian Government legislation, the minimum time you’ll have to wait before being able to claim on your hospital cover for the costs of joint replacement is two months. However, if your knee injury is considered a pre-existing condition when you join your health fund, you may have to wait a year before being able to claim.

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