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Shoulder Replacement Surgery Under Insurance- 100% Cashless

Most insurance policies in India cover the cost of shoulder replacement surgery. Read on to find out all about shoulder replacement surgery insurance coverage in India.

Most insurance policies in India cover the cost of shoulder replacement surgery. Read on to find out all about shoulder replacement surgery ... insurance coverage in India. Read More

Shoulder Replacement Treatment Insurance Claim

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Benefits of Choosing Pristyn Care Treatment with Insurance

Is Shoulder Replacement Covered Under Insurance?

Shoulder replacement is often performed to alleviate chronic pain or mobility issues caused by degenerative joint diseases such as osteoarthritis, rheumatoid arthritis, or avascular necrosis. These conditions can significantly impact a person’s quality of life and ability to perform daily activities, and surgery may be the most effective treatment option. Insurance companies typically covers orthopaedic procedures, and if a doctor deems that a shoulder replacement is necessary to improve a patient’s health and function, insurance may cover the cost.

Secondly, shoulder replacement surgery may be covered under insurance because it is considered a standard and widely accepted treatment for certain conditions.

However, it’s important to note that insurance coverage for shoulder replacement surgery can vary depending on the specific insurance plan and individual circumstances. Some plans may require a certain level of medical necessity or prior authorization, while others may have different coverage limitations or exclusions. It’s always best to check with your insurance provider to determine your specific coverage and any out-of-pocket costs you may be responsible for.

• Disease name

Shoulder Replacement

• Surgery name

Shoulder arthroplasty

• Duration

2 Hours

• Treated by

Orthopedic surgeon

Shoulder Replacement Surgery Cost Calculator

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How to get Shoulder Replacement under Insurance?

Both, health and Mediclaim insurance policies cover the cost of Shoulder Replacement.However, it is advised to choose an insurance policy that provides extensive benefits at an affordable price. At Pristyn Care, you get not only the best Surgery for Shoulder Replacement.but also a hassle-free experience during filing the health insurance and Mediclaim. We take care of the complete procedure, including insurance-related paperwork, of getting approval on an insurance claim. This is to ensure that the patient nor their family members have to face any additional hassles.

1 Intimation

Fill up the pre-auth form at the network hospital for cashless approval. Fill up the pre-auth form at the network hospital for cashless approval

2 Approval/Rejection

Fill up the pre-auth form at the network hospital for cashless approval. Fill up the pre-auth form at the network hospital for cashless approval

3 Hospitalisation

Hospitalisation can be done on the basis of pre-auth approvalHospitalisation can be done on the basis of pre-auth approval

4 Claim Settlement

At the time of discharge, we settle the claim directly with hospitalAt the time of discharge, we settle the claim directly with hospital

1 Hospitalization At Non Network Hospital

You need to pay the bills initially and preserve the original invoices

2 Register A Claim

Post hospital discharge send us all your invoices and treatment documents

3 Verification

We verify your claim related invoices and treatment documents

4 Claim Settlement

We send the approved claim amount to your bank account

Best Doctors for Shoulder Replacement Surgery

Dr. Kamal Bachani

MBBS, MS(Ortho), M.Ch(Ortho)

34 Yrs.Exp.

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6366-370-250

Dr. Pradeep Choudhary

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Dr. Nallamothu Anil Kuma...

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Costs Covered Under Health Insurance/Mediclaim

Shoulder replacement cost covered under a health insurance policy or mediclaim policy can vary depending on the policy terms, insurance provider, and the specific procedure being performed. In general, health insurance policies may cover the following expenses related to shoulder replacement surgery:

Pre-hospitalization and post-hospitalization expenses: This may include diagnostic tests, consultations, and medications prescribed before and after the surgery.
Room and board charges: This includes charges for the hospital room and other facilities used during the hospital stay.
Surgeon’s fees: This includes the fees charged by the surgeon for performing the surgery.
Anesthesia charges: This includes the fees charged by the anesthesiologist for administering anesthesia during the surgery.
Operation theater charges: This includes the fees charged for the use of the operation theater during the surgery.
Prosthetic implant costs: This includes the cost of the artificial joint used in the replacement surgery.
Physical therapy and rehabilitation costs: This includes the cost of physical therapy and rehabilitation services after the surgery.

It’s important to note that the extent of coverage for shoulder replacement surgery may also depend on the type of policy and the terms and conditions of the policy. Some policies may have specific exclusions or limits on coverage for certain procedures or treatments. It’s always best to review the policy documents carefully and consult the insurance provider to determine the specific coverage and any out-of-pocket expenses.

The cost covered under a health insurance policy or mediclaim policy for shoulder replacement surgery can vary depending on the policy terms, insurance provider, and the specific procedure being performed. In general, health insurance policies may cover the following expenses related to shoulder replacement surgery:

Pre-hospitalization and post-hospitalization expenses: This may include diagnostic tests, consultations, and medications prescribed before and after the surgery.
Room and board charges: This includes charges for the hospital room and other facilities used during the hospital stay.
Surgeon’s fees: This includes the fees charged by the surgeon for performing the surgery.
Anesthesia charges: This includes the fees charged by the anesthesiologist for administering anesthesia during the surgery.
Operation theater charges: This includes the fees charged for the use of the operation theater during the surgery.
Prosthetic implant costs: This includes the cost of the artificial joint used in the replacement surgery.
Physical therapy and rehabilitation costs: This includes the cost of physical therapy and rehabilitation services after the surgery.

All Major Insurances Accepted

What is the Difference Between Mediclaim and Health Insurance Policy?

The terms “mediclaim” and “health insurance” are often used interchangeably, but there is a subtle difference between the two.

Mediclaim typically refers to a type of health insurance policy that specifically covers hospitalization expenses related to an illness or injury. These policies usually have a limited scope and provide coverage for pre-specified illnesses, treatments, and medical procedures. For instance, a mediclaim policy may cover hospitalization expenses related to a surgery, but it may not cover outpatient expenses or preventive healthcare services.

On the other hand, health insurance is a broader term that encompasses a range of policies that provide coverage for various healthcare expenses. Health insurance policies can be classified into several categories, including individual health insurance, family health insurance, critical illness insurance, and group health insurance. Health insurance policies can offer a wider range of coverage options, such as outpatient care, preventive care, prescription drugs, mental health services, and more.

It’s important to note that the terms and scope of these policies can vary depending on the insurance provider, the policy terms, etc.

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FAQs Related to Shoulder Replacement Insurance Coverage

What is the cost of shoulder replacement surgery in India?

The average cost of shoulder replacement in India typically ranges from INR 1,20,000 to 2,50,000. This is the approximate cost range that may differ from the final cost of the shoulder replacement surgery based on the factors including the consultation fee of the orthopedic surgeon, choice of the hospital, type of surgery, and the severity of the affected shoulder joint, etc.

The average cost of shoulder replacement in India typically ranges from INR 1,20,000 to 2,50,000. This is the approximate cost range that may differ from the final cost of the shoulder replacement surgery based on the factors including the consultation fee of the orthopedic surgeon, choice of the hospital, type of surgery, and the severity of the affected shoulder joint, etc.

Here is a list of documents that you may require to claim the health insurance for shoulder replacement surgery: Valid identity proof Ambulance receipt Claim form The policy number Hospital pharmacy bills

What factors can affect the cost of shoulder replacement surgery in India?

If you are undergoing shoulder replacement surgery, then you must consider the following points while calculating the cost of surgery: Surgical approach Type of anesthesia administered Patient’s age and comorbidities Type of implant used for the surgery

Which insurance plan does Pristyn Care accept?

At Pristyn Care, we accept all kinds of insurance plans. We have a dedicated insurance team to provide complete assistance in claiming the insurance plan for shoulder replacement surgery.

Cashless Payment Service For Shoulder Replacement Surgery at Pristyn Care

Visit Pristyn Care to undergo safe and effective shoulder replacement surgery. We offer cashless payment services for shoulder replacement surgery. We provide options for cashless payment for rotator cuff surgery. Our first goal is to make sure that our patients are at ease and are not inconvenienced in any way during the course of their treatment. We provide complete insurance assistance, along with No Cost EMI offers, and multiple cashless payment modes.

To obtain more clarity, reach out to our dedicated team today.