Finder makes money from featured partners, but editorial opinions are our own.
Health insurance for hip replacement surgery
The cost of hip replacement surgery can be significant, but treatment can be covered by both Medicare and private health insurance. Compare your options for a hip replacement below.
The average cost of hip replacement surgery varies dramatically, but estimates often range in the $20,000 to $40,000 range. Bupa, for example, calculated an average surgery cost of $31,820.
The Medicare Benefits Scheme fee for hip replacement as of May 2021 is $1,359.00. Individual costs do differ, however. The below chart shows the different benefit amounts paid by insurers on average for a hip replacement doctor's fee.
There are a number of things you can do to work out your own estimate:
Call your surgeon to get their cost. The average cost of a hip replacement can vary by more than $20,000, so it's worth looking into.
Ask if your surgeon is on your private health insurer's preferred list to help find the most affordable option.
Ask for their extras cost as things like an anaesthetist can cost a lot.
Make sure there are no hidden out-of-pocket expenses like X-rays.
Ask for the Medicare code.
Call your private health insurer and give them your Medicare code.
Call the anaesthetist and ask for a cost estimate.
Find out your doctor's estimated rebate.
What do different insurers offer for hip replacement surgery?
Below are some examples from Finder Partners that cover joint replacement surgery. All prices are based on a single individual with less than $93,000 income and living in Sydney.
Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your income?
This is needed to calculate the correct Australian
government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Hospital
Extras
Combined (Extras + Hospitals)
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need?
Select as many as you want
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
Why compare with us
You'll pay the same price as going direct - we don't
charge fees
We don't ask for your phone or email to see prices
Hang tight - we're fetching policies just for you!
Comparing quotes from 30+ funds...
Finder survey: How many Australians have made a hospital claim for joint replacements?
Response
Male
Female
Joint replacements
2.92%
1.72%
Source: Finder survey by Pure Profile of 1006 Australians, December 2023
When might you need hip replacement surgery?
Hip replacement is usually recommended after other treatments like physical therapy, exercise and medication have failed to improve your condition. You may need a hip replacement if:
Your pain isn't improved by medication
Your hip has become weak and unstable
Pain stops or limits you from getting out and being as active as normal
Pain affects your sleep
How does Medicare cover hip replacement surgery?
Medicare covers most medically necessary surgeries like hip replacements. Public patients should have no out-of-pocket expenses for surgery in a public hospital. Additionally, Medicare pays 75% of the Medicare Benefits Schedule (MBS) to private patients in public hospitals, meaning it will cover 75% of the public rate for the surgery, anaesthesia and diagnostic work.
While Medicare provides hip replacements with little or no out-of-pocket expenses for public patients in public hospitals, you may have to wait several months before receiving surgery. It's also worth remembering that you won't be able to choose your doctor if using the public system.
How to claim the Medicare rebate
You can claim your Medicare benefit using your Medicare online account accessible through myGov or your doctor. Because hip replacements can be so expensive, with prices varying from $19,439 to $42,007 depending on the surgeon, it's essential that you do this in order to avoid a substantial bill.
Average public vs private wait times in Australia for hip replacement surgery
Source: Australian Institute of Health and Welfare (AIHW) Private health insurance use in Australian hospitals 2006–07 to 2016–17
How does private health insurance cover hip replacement surgery?
If you go private, you'll have your choice of surgeon and hospital. There's a good chance you'll also have more say over when the surgery takes place.
To be covered, you'd need a private hospital policy, normally medium to high level. If you're getting joint replacement cover for the first time you'll also have to serve a waiting period of 12 months.
For the treatment, you're likely to receive out-of-pocket costs depending on things like your excess and what your doctor charges. That's why it's important to do your research beforehand.
What does hip replacement surgery involve?
There are two types of hip surgery: anterior, where an incision is made at the front of the hip and posterior, where the incision is on the side. Each surgery has a slightly different procedure:
Anterior:
Anterior hip replacement is a minimally invasive approach associated with a faster early recovery for the patient.
The procedure is performed under general anaesthesia and a small incision is made, usually between three and six inches long on the front of the thigh.
The femur bone is then separated from the acetabular socket and any damaged cartilage and bone is removed and reshaped.
The acetabular prosthesis is secured using special cement or screws and the femur is prepared using special instruments so that the new prosthesis fits perfectly into the bone.
Posterior:
The procedure is performed under general anaesthesia: an incision is made close to the buttocks and the surgeon must part the muscle to gain access to the hip joint.
A posterior total hip replacement replaces the femoral head and acetabulum with artificial prosthesis.
In this case, the femoral head is removed and the femoral component is secured using cement or screws.
Your surgeon will slide the femoral head into its acetabular counterpart.
How long is the recovery time for hip replacement surgery?
Typically, patients return to normal life activities within one to six months. The most discomfort ordinarily comes after surgery where you'll probably feel some pain but will receive medication to ease the discomfort. 24 hours after surgery you'll be given exercises and a walking aid, such as a stick, to get you moving and begin strengthening the muscles around the hip.
Short-term recovery involves getting off painkillers and managing to sleep without discomfort. You'll find you're on the road to recovery when you no longer need any walking aid and can move about the house without pain. It usually takes around four to six weeks to get to this stage of recovery.
Long-term recovery is when you can return to work and do normal, daily activities. You should also find that surgical wounds and soft tissue have healed, generally feeling normal again.
Why you can trust Finder's health insurance experts
You pay nothing. Finder is free to use. And you pay the same as going direct. No markups, no hidden fees.
You save time. We spend 100s of hours researching health insurance so you can sort the gold from the junk faster.
You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
Was this content helpful to you?
Thank you for your feedback!
Written by
Gary Ross Hunter
Gary Ross Hunter is an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, The Guardian and news.com.au. Gary holds a Kaplan Tier 2 General Advice General Insurance certification which meets the requirements of ASIC Regulatory Guide 146 (RG146). See full profile
You can get cover for varicose vein treatment with Medicare or a Silver Insurance Policy, provided the treatment is medically necessary. Compare the costs of both below.
There are more than 10,000 prosthetic devices that can be covered through private health insurance. Here's how to identify if you're covered.
Feedback
How likely would you be to recommend Finder to a friend or colleague?
0
1
2
3
4
5
6
7
8
9
10
Very UnlikelyExtremely Likely
Required
Thank you for your feedback.
Our goal is to create the best possible product, and your thoughts, ideas and suggestions play a major role in helping us identify opportunities to improve.
Important information about this website
finder.com.au is one of Australia's leading comparison websites. We are committed to our readers and stands by our editorial principles
We try to take an open and transparent approach and provide a broad-based comparison service. However, you should be aware that while we are an independently owned service, our comparison service does not include all providers or all products available in the market.
Some product issuers may provide products or offer services through multiple brands, associated companies or different labeling arrangements. This can make it difficult for consumers to compare alternatives or identify the companies behind the products. However, we aim to provide information to enable consumers to understand these issues.
We make money by featuring products on our site. Compensation received from the providers featured on our site can influence which products we write about as well as where and how products appear on our page, but the order or placement of these products does not influence our assessment or opinions of them, nor is it an endorsement or recommendation for them.
Products marked as 'Top Pick', 'Promoted' or 'Advertisement' are prominently displayed either as a result of a commercial advertising arrangement or to highlight a particular product, provider or feature. Finder may receive remuneration from the Provider if you click on the related link, purchase or enquire about the product. Finder's decision to show a 'promoted' product is neither a recommendation that the product is appropriate for you nor an indication that the product is the best in its category. We encourage you to use the tools and information we provide to compare your options.
Where our site links to particular products or displays 'Go to site' buttons, we may receive a commission, referral fee or payment when you click on those buttons or apply for a product. You can learn more about how we make money.
When products are grouped in a table or list, the order in which they are initially sorted may be influenced by a range of factors including price, fees and discounts; commercial partnerships; product features; and brand popularity. We provide tools so you can sort and filter these lists to highlight features that matter to you.
Please read our website terms of use and privacy policy for more information about our services and our approach to privacy.
We update our data regularly, but information can change between updates. Confirm details with the provider you're interested in before making a decision.
You pay nothing. Finder is free to use. And you pay the same as going direct. No markups, no hidden fees.
You save time. We spend 100s of hours researching health insurance so you can sort the gold from the junk faster.
You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
