Home > Money > Question
Need Expert Advice?Our Gurus Can Help

Will My Health Insurance Cover Hip Replacement Surgery?

Ramalingam

Ramalingam Kalirajan  |7281 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Jul 25, 2024

Ramalingam Kalirajan has over 23 years of experience in mutual funds and financial planning.
He has an MBA in finance from the University of Madras and is a certified financial planner.
He is the director and chief financial planner at Holistic Investment, a Chennai-based firm that offers financial planning and wealth management advice.... more
Sudhakar Question by Sudhakar on Jul 14, 2024Hindi
Listen
Money

Hi sir good evening hip replacement surgery cover by health insurance plz help me

Ans: Health insurance policies typically cover various medical procedures, including surgeries. Hip replacement surgery is a significant medical procedure, and understanding its coverage under your health insurance is crucial. Let’s break it down.

Coverage for Hip Replacement Surgery
Inclusion in Policies

Major Surgeries: Most comprehensive health insurance plans cover major surgeries, including hip replacement.

Hospitalisation Costs: Covers hospitalisation expenses, including room rent, doctor fees, and nursing charges.

Pre- and Post-Hospitalisation

Medical Tests: Pre-hospitalisation expenses, like diagnostic tests, are often covered.

Follow-Up: Post-hospitalisation expenses, such as follow-up visits and medications, are typically included.

Checking Your Policy
Policy Document

Terms and Conditions: Review your health insurance policy document for specific coverage details.

Exclusions: Look for any exclusions related to hip replacement surgery.

Customer Support

Insurance Provider: Contact your insurance provider’s customer support for clarification.

Detailed Information: Ask for detailed information about coverage limits and conditions.

Additional Considerations
Waiting Periods

Initial Waiting Period: Check if there is an initial waiting period before you can claim for surgeries.

Specific Waiting Period: Some policies may have a specific waiting period for certain surgeries.

Co-Payment Clause

Shared Costs: Some policies have a co-payment clause, where you pay a part of the expenses.

Percentage: Understand the percentage you need to co-pay.

Disadvantages of Index Funds
Lack of Flexibility

Fixed Portfolio: Index funds have a fixed portfolio, limiting flexibility.

Underperformance: They may underperform compared to actively managed funds.

Benefits of Regular Funds
Professional Management

Expertise: Managed by professional fund managers.

Higher Returns: Potential for higher returns compared to direct funds.

Importance of a Certified Financial Planner
Expert Guidance

Personalised Advice: Provides tailored advice based on your specific needs.

Continuous Support: Offers ongoing support and adjustments to your financial plan.

Final Insights
Review Your Policy: Always review your health insurance policy for specific coverage details.

Seek Professional Help: Consider consulting with a certified financial planner for expert guidance.

Stay Informed: Stay informed about your policy terms and conditions to avoid surprises.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in
DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Users are advised to pursue the information provided by the rediffGURU only as a source of information to be as a point of reference and to rely on their own judgement when making a decision.
Money

You may like to see similar questions and answers below

Ramalingam

Ramalingam Kalirajan  |7281 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Apr 16, 2024

Asked by Anonymous - Apr 02, 2024Hindi
Listen
Money
i have tata aig insurence can i get money for reservice of hip joint i had been operated for both hip replacemt done 15 yrs back
Ans: The coverage for hip joint replacement surgery under your Tata AIG insurance policy would depend on the specific terms and conditions of your policy. Generally, health insurance policies may cover joint replacement surgeries, including hip replacement, if it is deemed medically necessary.

Here are steps to determine coverage:

Review Policy Document: Check your Tata AIG insurance policy document to understand the coverage details, exclusions, and limitations related to joint replacement surgeries.

Pre-Authorization: Before undergoing the surgery, it's essential to inform the insurance company and obtain pre-authorization for the treatment. This process involves submitting relevant medical documents and getting approval from the insurer.

Claim Submission: After the surgery, submit a claim to Tata AIG along with all the necessary documents, including medical bills, doctor's prescription, hospitalization records, and pre-authorization approval letter.

Policy Coverage: Review the policy's coverage limit, co-payment, deductibles, and any waiting periods related to joint replacement surgeries.

Exclusions: Be aware of any exclusions related to pre-existing conditions, waiting periods, or specific treatments not covered under your policy.

Claim Settlement: Once the claim is submitted, Tata AIG will review the documents and process the claim as per the policy terms. If the surgery is covered under your policy, you may receive reimbursement or cashless treatment as per the policy terms and conditions.

Alternative Coverage: If the joint replacement surgery is not covered under your current policy or the coverage is insufficient, consider exploring additional health insurance options or upgrading your existing policy to include better coverage for such treatments.

It's crucial to read the policy document carefully and consult with Tata AIG customer service or your insurance agent to understand the coverage details and claim process related to hip joint replacement surgery. Remember to keep all the medical records and bills safely for claim submission and reimbursement.

..Read more

Ramalingam

Ramalingam Kalirajan  |7281 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Jul 25, 2024

Listen
Latest Questions
Dr Shyam

Dr Shyam Jamalabad  |83 Answers  |Ask -

Dentist - Answered on Dec 19, 2024

Asked by Anonymous - Dec 12, 2024Hindi
Listen
Health
Doctor, I’ve recently noticed that my gums bleed a little when I brush, and they feel a little tender, especially around the back. I did some quick research online, and it sounds like it could be gingivitis, but I’m not really sure. I’ve always been pretty regular with brushing, but I might not be doing it thoroughly, and I don’t always floss. I am 38 and was wondering, is it possible for me to treat or even cure gingivitis by myself at home? Should I just start using a specific mouthwash or change my brushing routine? Or is this something I should see a dentist about right away? I’m hoping it’s something simple I can handle without needing a visit to the dentist.
Ans: Mild gingivitis can be treated and managed at home with good oral hygiene practices and some natural remedies. However, if the condition persists or worsens, it's essential to consult a dentist for professional treatment.

Home Treatment and Prevention:

1. *Brushing and Flossing*: Brush your teeth at least twice a day and floss once a day to remove plaque and food particles.
2. *Saltwater Rinse*: Rinse your mouth with warm saltwater several times a day to reduce inflammation and kill bacteria.
3. *Antibacterial Mouthwash*: Use a commercial hydrogen peroxide/chlorhexidine gluconate mouthwash to kill bacteria and reduce inflammation.
4. *Dietary Changes*: Eat a balanced diet rich in fruits, vegetables, and whole grains, and avoid sugary and processed foods.
5. *Vitamin C* plays a significant role in gingival health. So make sure you have fresh citrus fruits (preferably unrefrigerated) on a regular basis. The other option is to take Vitamin C supplements.

When to Consult a Dentist:

1. *Persistent Gingivitis*: If your gingivitis persists despite good oral hygiene practices and home remedies.
2. *Severe Symptoms*: If you experience severe symptoms like bleeding gums, pain, or swelling.
3. *Gum Recession*: If you notice gum recession or exposed roots.
4. *Loose Teeth*: If your teeth become loose or mobile.


Remember, while home treatment and natural remedies can help manage mild gingivitis, regular dental check-ups and professional cleanings are essential to prevent and treat gum disease.

...Read more

Ravi

Ravi Mittal  |471 Answers  |Ask -

Dating, Relationships Expert - Answered on Dec 19, 2024

Asked by Anonymous - Dec 19, 2024Hindi
Listen
Relationship
I 32F have been dating my boyfriend for about a year now. He has a young daughter from his previous marriage, and they share custody. I’ve been trying to get along with his ex-wife, but it’s been really difficult. She often contacts him for things that aren’t urgent and it feels like she’s overstepping into our relationship, especially when it comes to decisions about their daughter. I understand that they need to co-parent, but I feel like I’m always left out or made to feel uncomfortable. My boyfriend says he tries to balance everything, but sometimes I feel like his ex-wife has more influence in his life than me. How can I set healthy boundaries with her without causing tension, and how can I talk to my boyfriend about how I’m feeling without sounding like I’m being controlling?
Ans: Dear Anonymous,
I understand that you are in a tricky spot but it is important to understand that when it comes to their child, they have the right to make decisions and ignore everyone else's, even yours. You should keep your relationship and their co-parenting situation separate. Having said that, if you think your BF's ex is overstepping, communicate that to your partner, while letting him know that it bothers you and might even create friction in your relationship. An open and honest discussion is the only way around it. If expressing your discomfort is causing tension or considered ‘controlling,’ then you need to rethink the relationship.

I am sure your partner is truly trying to balance things, but since he is dating you, he should be aware of the areas where that balance is lacking. Communication is the only way.

Hope this helps.

...Read more

DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Investment in securities market are subject to market risks. Read all the related document carefully before investing. The securities quoted are for illustration only and are not recommendatory. Users are advised to pursue the information provided by the rediffGURU only as a source of information and as a point of reference and to rely on their own judgement when making a decision. RediffGURUS is an intermediary as per India's Information Technology Act.

Close  

You haven't logged in yet. To ask a question, Please Log in below
Login

A verification OTP will be sent to this
Mobile Number / Email

Enter OTP
A 6 digit code has been sent to

Resend OTP in120seconds

Dear User, You have not registered yet. Please register by filling the fields below to get expert answers from our Gurus
Sign up

By signing up, you agree to our
Terms & Conditions and Privacy Policy

Already have an account?

Enter OTP
A 6 digit code has been sent to Mobile

Resend OTP in120seconds

x