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Joint replacement health insurance

Health insurance can help cover the cost of replacing your hips, knees and other joints.

What you need to know

  • Joint replacements are covered under all gold hospital policies, as well as some silver plus policies.
  • Cover for joint replacements starts from around $38 a week.
  • Medicare will cover most of the cost in the public system, but surgery wait times are very long.

Compare joint replacement health insurance

Below are some of the cheapest policies from Finder partners that cover joint replacement – most are silver plus policies, rather than gold policies. To compare health insurance from 30+ funds, click here.

1 - 20 of 41
Name Product Treatments Price Apply
Frank Max Hospital 750 (Silver+)
Silver Plus$750 excess
Frank Health Insurance logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +24 other treatments covered
$169.10
per month
Go to Site
All treatments
Bupa logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +26 other treatments covered
$171.44
per month
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All treatments
HCF logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +26 other treatments covered
$174.38
per month
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All treatments
Medibank Silver Plus Secure
Silver Plus$750 excess
Medibank Private Limited logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$175.81
per month
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All treatments
Qantas Insurance logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$178.45
per month
Go to Site
All treatments
nib logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$179.16
per month
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All treatments
Silver Plus Hospital $750/$1500
Silver Plus$750 excess
Health Insurance Fund of Australia Limited logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$180.26
per month
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All treatments
GMHBA Limited logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$180.90
per month
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All treatments
HCF logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +26 other treatments covered
$183.73
per month
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All treatments
HBF logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +26 other treatments covered
$183.92
per month
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All treatments
Medibank Silver Plus Secure
Silver Plus$500 excess
Medibank Private Limited logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$187.27
per month
Go to Site
All treatments
GMHBA Limited logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$188.07
per month
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All treatments
Silver Plus Advanced Hospital 750
Silver Plus$750 excess
AIA Health Insurance Pty Ltd logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$189.13
per month
Go to Site
All treatments
Silver Plus Hospital $500/$1000
Silver Plus$500 excess
Health Insurance Fund of Australia Limited logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$189.91
per month
Go to Site
All treatments
Qantas Insurance logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$190.39
per month
Go to Site
All treatments
nib logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$190.97
per month
Go to Site
All treatments
HBF logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +26 other treatments covered
$195.83
per month
Go to Site
All treatments
Silver Plus Advanced Hospital 500
Silver Plus$500 excess
AIA Health Insurance Pty Ltd logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$199.05
per month
Go to Site
All treatments
HCF logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +26 other treatments covered
$200.77
per month
Go to Site
All treatments
Silver Plus Hospital $200/$400
Silver Plus$200 excess
Health Insurance Fund of Australia Limited logo
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$205.67
per month
Go to Site
All treatments
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All prices are based on a single individual with less than $93,000 income and living in Sydney.

Is joint replacement covered by Medicare?

Public system

Public system

Medicare will pay for all of the cost of a joint reconstruction in a public hospital. There should be minimal out-of-pocket costs to pay, although there may be some, depending on your circumstances. The main downside of using the public system is that you'll have longer surgery wait times. In 2021–22, wait times were around 153 days for a hip replacement and 293 days for a knee replacement.

Private system

Private system

In the private system, Medicare will pay some of the cost, but you'll need to cover the rest. Specifically, the Medicare Benefits Schedule (MBS) lists benefits for a wide range of joint replacements, but Medicare only covers 75% of the listed fee. That means you'll need to pay the remaining amount out of pocket or by using private health insurance.

Is joint replacement covered by health insurance?

Joint replacement is covered by all gold-tier private hospital insurance policies but several silver plus policies will also cover you.

It can cover you for:

  • Accommodation in a public or private hospital
  • Theatre fees
  • In-hospital pharmaceuticals
  • Doctor and specialist fees
  • Prostheses
  • Physiotherapy fees to help with your recovery

Your private health insurer will also cover the cost of the surgically implanted prosthises used to replace your joint. The Australian government's Prostheses List outlines all the prostheses for which private health insurers must pay a benefit.

Out-of-pocket costs for joint replacements

Even with private health insurance, there will probably be an additional cost (or gap) that you will have to pay. The amount covered by health funds varies significantly, as does the amounts charged by surgeons. This can affect the out-of-pocket costs that you have to pay on top of your private health insurance, with the differences sometimes in the thousands of dollars. Make sure you speak to your health fund, GP and any prospective surgeon about the final cost of the surgery.

Waiting periods for joint replacements

There are 2 types of waiting period that are relevant to joint replacements, but the terms are similar. There's the health insurance waiting period then there are the public hospital surgery waiting times.

Health insurance waiting period

When you get private health insurance that covers joint replacements, there is a 2-month waiting period before you can make a claim. If you have a pre-existing condition (including arthritis) then you'll need to wait for 12 months before you can claim.

Public hospital surgery waiting times

If you decide to use Medicare and get a joint replacement in the public system, then you'll have to wait for you surgery to be scheduled. Unfortunately, there are lots of public patients that need joint replacements and waiting times have increased significantly since the COVID-19 pandemic. In 2021–22, the wait time for a total hip replacement was around 153 days and the wait time for a total knee replacement was 293 days. Going private can help you get surgery much sooner than this.

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Frequently asked questions

Written by

Tim Bennett

Tim Bennett is a Finder insurance expert. For over 10 years he's reported on news, politics, finance and other topics as a journalist and radio presenter. Tim's roles have included radio news reader and breakfast at the ABC, news producer for SBS and producer for Fairfax Media. Tim regularly appears as a health insurance expert on programs like Sunrise and SBS news, as well as in the Australian, The Daily Telegraph, The Courier Mail and more. See full profile

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