Cover for joint replacement procedures, including hip, shoulder, ankle and knee replacement surgery.
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Price based on :
Singles cover in VIC. I'm Under 65 with an income $105,000 or less, Rebate Tier 0 and a 4% discount for direct debit.
Joint replacement surgery is a procedure that replaces a damaged or worn joint with an artificial implant. Common types of joint replacement surgery include hip replacement surgery and knee replacement surgery.
It is commonly recommended when joint pain, stiffness and reduced mobility begin to affect everyday activities and other treatments are no longer providing sufficient relief.
The procedure aims to reduce pain, improve mobility and help people return to everyday activities with greater comfort and confidence.
Yes. Joint replacement surgery is covered by private hospital insurance when your policy includes Joint Replacement as a Clinical Category and any applicable waiting periods have been served.
Joint Replacements is an Australian Government-defined Clinical Category that covers procedures such as hip, knee, shoulder and ankle replacement surgery.
Before undergoing surgery, it's a good idea to check:Under the Australian Government's hospital cover tiers, Joint Replacements are included in Gold hospital cover, and health funds have also the option to include in other tiers as well. Many of Australian Unity’s Silver Plus products include joint replacement. View health insurance with joint replacement cover.
The most important thing to check is whether the policy specifically includes Joint Replacements. This is more important than whether the policy is labelled Silver Plus, Gold or other tiers.
Hip replacement surgery replaces a damaged hip joint with an artificial joint and is commonly performed to treat advanced osteoarthritis and other degenerative joint conditions.
Knee replacement surgery replaces damaged parts of the knee joint and is a common treatment for advanced knee osteoarthritis and other conditions that cause ongoing pain, stiffness and reduced mobility.
Shoulder replacement surgery may be recommended when arthritis, injury or joint degeneration causes ongoing pain and limited movement.
Ankle replacement surgery replaces damaged parts of the ankle joint and may be considered when severe arthritis significantly affects mobility.
Both Medicare and private health insurance can help you access cataract surgery, but the experience can be quite different.
As a public patient under Medicare, you'll generally be treated through the public hospital system and may need to join a waiting list before surgery. You may also have limited choice over your surgeon and hospital. The benefit is that you won't pay hospital accommodation charges as a public patient.
With private health insurance, you typically have more choice and control over your treatment, including where you're treated, when you have surgery, and which specialist performs the procedure.
| Medicare (Public System) | Private health insurance with joint replacement cover | |
|---|---|---|
| When you can have treatment | Treatment is subject to public hospital waiting lists, which can sometimes be lengthy. | Treatment may be available sooner. If you haven't previously held cover that includes Joint Replacements, you may need to serve a waiting period, often 12 months. After that, you'll generally have more flexibility when choosing a hospital and specialist. |
| Where you can have treatment | Public hospitals allocated through the public healthcare system. |
Choice of participating private hospitals and, in some cases, public hospitals. |
| Who can treat you | Limited ability to choose your specialist. | |
| Cost to have the surgery | No hospital accommodation charges, surgeon or anaesthetist fees. Although you may still incur costs for appointments, tests or medications outside your hospital stay. |
Depending on your policy, you may pay an excess or co-payment. Out-of-pocket costs may also apply for services such as your anaesthetist, or out-of-hospital costs like appointments. |
Private health insurance can help cover many of the costs associated with joint replacement surgery, including hospital accommodation and theatre costs, provided Joint Replacements are included in your cover and any waiting periods have been served.
However, you may still need to contribute towards some costs, including:
The amount you'll pay depends on your policy, your specialists and the hospital where you're treated. Before surgery, ask your specialist for informed financial consent, which outlines any expected out-of-pocket costs so you can make an informed decision about your treatment.
With Australian Unity, our hospital cover gives eligible members access to Gap Cover, which can help reduce or eliminate some out-of-pocket costs when participating doctors use the scheme.
For many Australians, private hospital treatment may provide access to surgery sooner than treatment as a public patient. Waiting times depend on:
Private health insurance policies that include Joint Replacements can help cover the cost of joint replacement surgery as a private patient.
If you're looking for affordable hospital cover, our Value Hospital cover includes Joint Replacements and comes with a $100 daily co-payment, helping to keep premiums lower while still providing cover for a range of hospital treatments, including joint replacements. If you'd prefer to avoid a co-payment, Classic Hospital is another option that includes cover for Joint Replacements.
For broader cover, a combined hospital and extras policy such as Secure Choice includes Joint Replacements as well as extras cover for services commonly used before and after surgery, such as physiotherapy and other health services that support mobility and overall wellbeing.
Not sure which option is right for you? Call us on 1800 760 719 for help comparing your options, or explore hospital cover options that include joint replacements.
Yes, in many cases, private treatment offers greater specialist choice.
Before booking a surgery like a hip replacement or knee replacement, confirm:
Recovery is an important part of the joint replacement journey. Most people begin rehabilitation shortly after surgery to help rebuild strength, improve flexibility and restore movement in the joint.
Recovery plans may include:
Recovery time varies from person to person, but following your healthcare team's advice can help support the best possible outcome.
Eligible Australian Unity members may also be able to access Hospital Care at Home programs following surgery, where clinically appropriate and approved. Depending on the product, Australian Unity extras cover may support recovery by helping with the costs of physiotherapy, gym memberships and support equipment.
Yes. Medicare covers eligible joint replacement surgery when you're treated as a public patient in a public hospital. While there are generally no hospital accommodation charges as a public patient, waiting times may apply and you may have less choice over your hospital and specialist.
Joint replacement surgery may be recommended for people experiencing:
Yes, hospital cover that includes Joint Replacement will cover hip replacement surgery. Find cover that includes hip replacement cover.
Health insurance policies that include the Joint Replacements clinical category can help cover the cost of hip replacement surgery as a private patient. Cover like Value Hospital, Classic Hospital or even Secure Choice.
Not sure which option is right for you? Call us on 1800 760 719 for help comparing your options, or explore the hospital cover options that include hip replacement surgery.
Knee arthroscopy and ACL reconstruction procedures generally fall under the Joint Reconstruction Clinical Category rather than Joint Replacements. Which are often available under lower levels of hospital cover. Check your policy documents to confirm which clinical categories are included and whether waiting periods apply.
Yes. Knee replacements are covered under hospital cover. When comparing policies, check that joint replacements are included, as this is the Clinical Category that applies to knee replacement surgery. Don’t confuse joint replacements with joint reconstructions, which covers different procedures and does not include knee replacements. All types of knee replacements will be covered under this category including:
