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    Types of Health insurance

    Navigating Knee Replacements in Australia: A Comprehensive Guide

    Navigating Knee Replacements in Australia A Comprehensive Guide
    Megan Fraser Fact Checked Updated: 16 November 2023
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    Knee replacement surgery is often conducted when a patient is in consistent pain and mobility in the area decreases. Knee joint issues can often impact many facets of a patient’s life. Opting for a knee replacement surgery is a good way to not only lower pain but also to get back into the swing of life.

    Although knee replacement surgery is common, equipping yourself with the knowledge of the procedure will grant you the peace of mind that you need before the surgery. Today we will discuss everything that there is to know about knee replacement surgery, the costs involved, the recovery process as well as how you can select a surgeon that matches your requirements.

    Key facts

    • Understanding the procedure, the costs and the road to recovery will assist you in being more comfortable with the surgery.
    • The average out-of-pocket cost across Australia for this procedure is around $680. This amount may vary depending on your state, hospital of choice, and selected Private Health Insurance Policy.
    • Taking care of your knee after the surgery is essential in ensuring the operation’s success.

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    Understanding Knee Replacement Surgery

    Knee joint issues are often a result of the joint being damaged, worn out or diseased. When this occurs, it can cause consistent pain and inflammation around the area. This issue may also cause simple tasks to become noticeably more difficult with time.

    During the procedure, the surgeon will open and remove any damaged, diseased or worn-out pieces of joint that may be causing the issue to persist. Once removed, the surgeon will replace these missing pieces with an artificial joint piece. This joint piece is designed to act exactly as a regular joint would.

    Types of knee surgery

    There are two main procedure types for this surgery. Total knee replacement and partial knee replacement. Total knee replacement is the most common of the two but during this procedure, the entire joint is replaced with an artificial surface. In a partial knee replacement, only the damaged, worn-out and diseased compartments of the joint are replaced.

    Who qualifies

    You may be considered a candidate for knee replacement surgery if you experience consistent pain, if simple tasks such as walking up and down stairs become difficult and if you notice a steady or drastic decline in your mobility. It is suggested that you speak to your doctor before the surgery to ensure that you receive the best treatment.

    Knee Surgery Blog

    How much does a knee replacement cost?

    A knee replacement surgery’s cost varies from state to state and surgeon to surgeon. The out-of-pocket fee that you may be expected to pay will also vary based on the Health Insurance Provider that you have chosen and the hospital of choice. The average out-of-pocket fee for this procedure is around $680, with the highest average out-of-pocket amount being $3,900. The average specialist fee in Australia ranges from $4,000 to $8,800, depending on the state of residence.

    Some of the additional costs that could occur during the procedure may include:

    Recovery After Knee Replacement

    Once your knee replacement surgery is successfully completed, taking good care of the area is essential. Although the knee joint may be replaced and the problem areas removed, your body still needs time to heal and rest. Do not be alarmed if you feel pain in the operation area. It is normal to feel pain, especially in the first few weeks. It takes roughly a year to recover after a successful knee replacement procedure. During this time, there are a few things that you can do to ensure that your knee is receiving the best possible care it needs. 

    The path to recovery may be different depending on the patient, but here are some general points that your doctor may suggest:

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    Physical Therapy and Extras Cover

    After your surgery, you will work closely with a physical therapist. These physical therapy sessions are designed to ease the affected area back into perfect function. Some exercises associated with these therapy sessions will teach you how to move, bend your knees and walk safely. You might also be given a list of exercises that will assist you in your recovery journey. These exercises will ensure that function is properly restored to your knee joint.

    Extras Cover helps you manage the financial burden of those essential physical therapy sessions. With this cover, you can focus on your exercises and recovery, instead of stressing over bills. It’s tailored to support you in regaining full knee function without financial strain. Extras Cover, financial burden, physical therapy sessions, focus, exercises, recovery, knee function, financial strain.

    Knee Replacements and Private Health Insurance in Australia

    Depending on your chosen Private Health Insurance provider, the out-of-pocket fees that you may pay could vary. It is also important to note the different types of tiers within the policy structure of every Private Health Insurance Provider. Speaking with your insurance provider before the surgery will assist you in getting a clear picture of what will and will not be covered during the procedure. It is also crucial to note that Private Health Insurance Providers offer three types of policies: Hospital, Extras and Combined. Depending on your personal requirements, choosing between these policy types will ensure that you receive the necessary coverage.

    As a public patient in a public hospital, the average wait time for a knee replacement procedure is around 18  weeks. The average wait time for private patients in a private hospital is 4-6 weeks. Although private patients may receive care faster, it is often more expensive. If the area requires urgent treatment, it may be best to opt for private treatment. If you believe that the affected area does not need urgent care, the public option would be best suited for your needs. 

    How to choose cover for this type of procedure

    Here are a few questions that you should ask your Private Health Insurance provider before selecting a policy:

    Common Mistakes to Avoid

    One of the most common mistakes that is made after the operation is pushing yourself back into the routine the moment you exit the procedure. The affected area, and your body, still needs time to heal. Activities such as gyming, driving and returning to work can greatly affect your body’s ability to recover successfully from the operation.

    Another common mistake is skipping physical therapy sessions. Although these sessions may, in some cases, disrupt your usual schedule, it is crucial that you always attend your physical therapy sessions. These sessions are designed to get you back on track with the recovery process and restore function to the affected area.

    Frequently Asked Questions and Answers

    • How do I determine if I need a knee replacement?

      If you experience consistent pain in your knee area affecting your quality of life, you may need knee replacement surgery. Decreased mobility and increased difficulty performing basic tasks are other symptoms you should be aware of. If you are experiencing any pain, sensation, or mobility difference that is concerning, it is always best to consult with your doctor as soon as possible to address the issue. Before having the knee replacement surgery, your doctor will often opt for alternative methods that may better your situation. If these alternative treatments do not work, the doctor may suggest you schedule a knee replacement surgery appointment.
    • How long will it take to recover fully from knee replacement surgery?

      It takes roughly a year to recover from this surgery. During this time, you will work closely with a physical therapist who will assist you in restoring function to your knee joint. Other forms of care are essential in the recovery journey, such as icing your knee for 20 minutes multiple times a day and keeping your leg elevated above the level of your heart as often as you can. To ensure that the operation is a success, the patient mustn’t place too much strain and stress on the operated area.
    • What are the risks associated with knee replacement surgery?

      The benefits of this procedure far outweigh the risks associated with the surgery. Although this may be the case, some of the risks involved with this procedure include Infection, blood clots, nerve issues, issues with blood vessels, scar tissue inside the knee, and reduced range of motion. Speaking with your doctor about the recovery process and identifying issues before they continue will maintain the recovery journey.
    • How does private health insurance in Australia cover knee replacement surgery?

      Depending on your health insurance policy, the costs associated with the surgery, such as hospital fees, surgeon fees, and out-of-pocket fees, may be covered. Most Private Health Insurance Policies provide additional assistance known as ‘gap cover’, which assists with the out-of-pocket fees. Speaking with your provider before the surgery will give you a good estimate of what is covered.
    • What should I consider when choosing a health insurance policy for covering knee replacement surgery?

      Some key tips to remember when choosing a health insurance policy would be the price of the policy, the waiting period until coverage begins, out-of-pocket expenses, gap cover, and anything additional that the Health Insurance Provider may cover that Medicare does not. Comparing the prices alongside the coverage type and estimated out-of-pocket cost will ensure you choose the policy that meets your requirements.

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