Insuring Against Bone Diseases: A Guide for Families with Ageing Parents

According to news reports, orthopaedic experts in Tiruchy are urging the Tamil Nadu government to improve early detection and expand insurance coverage, citing a rise in bone-related ailments like arthritis and osteoporosis among elderly women due to age, poor nutrition, and inactivity. Bone health issues are more prevalent among the elderly, and hence, one needs to plan for that.

The good news is that standard health insurance policies cover surgeries related to bones. “In fact, knee replacement and hip replacement are some of the common surgeries claimed under health insurance.  Most policies would have a two to four-year waiting period for elective surgeries such as knee replacement,” says Abhishek Bondia, director, Insurance Brokers Association of India (IBAI).

You can also get coverage if you are already suffering from any bone condition.  “If the insured already has osteoporosis or osteoarthritis while buying the policy, these medical conditions are treated as pre-existing and are covered after the applicable waiting period,” says Ajay Shah, head – distribution, Care Health Insurance.

Choose A Suitable Rider 

What is heartening, though, is the increasing availability of disease-specific riders and specialty plans that are more attuned to the needs of elderly citizens. These policies are customised to cover bone-related issues of the elderly.

“They come with shorter waiting periods, have coverage for physiotherapy and even some medical aids, coming at it from a more holistic perspective, and not as a singular occurrence,” says Rajesh Kakkar, business head, Zuari Insurance Brokers.

What To Look For 

While evaluating a comprehensive health insurance plan for bone-related health concerns in the elderly, one should start by checking the waiting period for pre-existing conditions like osteoporosis, osteoarthritis, or other degenerative bone conditions. “One should also examine whether there are any sub-limits, co-payments, or any exclusions for orthopedic conditions like joint replacements, implants, etc,” says Ajay Shah, head, distribution, Care Health Insurance.

Furthermore, one should opt for a plan that provides coverage for diagnostic tests like bone scans, MRIs, X-rays, and so on, as these can be heavy on your pocket. Make sure your health insurance covers pre-hospitalization expenses and post-hospitalization expenses. “Pharmacy and physiotherapy sessions, as well as domiciliary treatment for recovery, are included in many health insurance products.

A higher sum insured or top-up policy may offer an adequate financial cushion against expensive medical treatments related to bone health. “Lastly, one should carefully examine the insurer’s network of cashless healthcare providers — if the hospital of your preference is included, and is equipped with a strong orthopedic & rehabilitation department,” says Shah.

When selecting a plan, families do not just consider the cost. See if the policy offers frequent health checkups, pays well for major treatments, and doesn't have excessive conditions or restrictions. “Good bone health insurance is not solely about surgery coverage; it's about ensuring elderly people remain active, comfortable, and independent as long as possible,” says Kakkar.