Movers and shakers: Do you need hip or knee surgery?

Chronic hip and knee pain can be debilitating and impact our mobility and lifestyle. When other therapies fail, hip and/or knee replacement surgery may be the solution. 

Our joints work hard to keep us moving, especially our hips and knees, and they also bear our weight. As we age, they can change — just like the rest of our body. By the time we’re fifty, we could’ve taken more than 86 million steps in our adult life if we’re taking 7,400 steps a day (the average for an Australian adult). That’s a lot of distance covered! On top of that, injury, illness, and other lifestyle factors can intensify the wear and tear of our hips and knees.

Hip and knee replacement surgery have become quite common in Australia, with the Australian Institute of Health and Welfare’s latest stats showing that in the 2021–22 period, 53,500 knee replacements and 35,500 hip replacements were performed. 

The effectiveness of hip and knee replacement surgery is monitored by the Australian Orthopaedic Association National Joint Replacement Registry, which was established in 1993 to ensure that the quality of care being provided to patients is maintained at world-class levels.

If you’re thinking of getting hip or knee replacement surgery, here’s what you need to know to ensure you’re able to book the procedure with confidence and plan your hospital stay without any niggling worries.

How to choose the right orthopaedic specialist 

Choosing the right specialist will ease any concerns you have about your surgery and health, and it may also save you a lot of money and time that you could otherwise waste on a health care practitioner who isn’t the right fit for you.

When your GP gives you a referral for a specialist, be sure to ask them questions to understand why they think that specialist might be the best for you. Also, remember that you can always ask your GP to refer you to a specialist that you feel is right for you — whether someone you know has recommended them, you’ve seen good reviews, or have read about their work in medical journals. 

Cost is also an important factor to consider when choosing a specialist — because there are many surgeons who may charge much more than you’re able or willing to pay. This is why having a health insurance policy could be an advantage.

Medicare can cover the entire cost of your knee or hip replacement surgery if you get the procedure through a public hospital or a part of the cost if you opt for a private hospital. However, you won’t have the option to select your own surgeon. Plus, the waiting times can vary from months to a year to even longer, varying slightly in different states and territories. In New South Wales alone, the latest figures reported by Channel 9 show 24% of people needing hip replacement surgery and 37% of people needing knee replacement, waited more than a year.

Seniors Health Insurance is backed by nib — an established health insurer trusted by 1.7 million Australians. nib consider themselves to be more than your health insurer — they want to be your health partner. As an Australian Seniors customer, you can take advantage of their nib Clinical Partners program. 

Advantage of the nib Clinical Partners Program

Cost-effective care

As a Seniors Health Insurance policy holder, you’ll have access to nib’s incredible network of orthopaedic surgeons — known as nib clinical partners — in New South Wales, Queensland, Tasmania, South Australia, and Western Australia. They’re experts in their field who have committed to not charging out-of-pocket expenses when performing hip and knee replacement surgery on our policy holders.

If your health cover lists joint replacement surgery as a benefit, and you’ve served your waiting period, then the full cost of your hospital procedure will be covered by your insurance. The only cost you’ll incur is your hospital excess. This means you’ll be saving tens of thousands of dollars as these types of surgeries average at more than $25,000 — unless you go the public hospital route and get placed on an elective surgery waiting list, where Medicare can cover all the cost.

Added support and care

Through the nib Clinical Partners Program, you’ll also have access to a health facilitation specialist from Honeysuckle Health, a partner health service company, who’ll guide you in preparing for your surgery through to recovery, even calling to check up on you once you’re back home from the hospital. 

Option to recover from home

If your surgeon agrees, you may be given the opportunity to come home earlier from the hospital and recover in the comfort of your own home. 

Instead of you having to organise transport and make your own way to a physiotherapist, through this program, they’ll visit you at home. They’ll help you rebuild your joint strength and mobility and teach you pain management techniques.

Not all specialists charge the same

It’s important to remember that not all orthopaedic surgeons charge the same amount — there’s no set price, even though the Medical Services Advisory Committee lists appropriate fee amounts in the Medicare Benefits Schedule, surgeons don’t have to abide by it. They have the autonomy to decide their fees based on a number of factors — unique patient circumstances, how in demand they are, and if they’re located in a more expensive suburb or city, to name a few.

Find the right specialist

Ready to reclaim your mobility and benefit from a hip or knee replacement surgery? Search nib’s clinical partners network and find the right specialist for you.

Hip and knee surgery can benefit you if you’re facing chronic pain every time you move. 

Looking after your health is important as you grow older. Being prepared for health-related costs like hip and knee replacement surgery by considering Seniors Health Insurance could help. 

Latika Mani

Insurance insights writer, cat lover, baking enthusiast