Does health insurance cover my hip replacement?  

If you’re among the many Australians awaiting a hip replacement, you’re in good company. Around 35,500 total hip replacements are done every year in Australia, and for those who go through a public hospital, the average wait is around 175 days. That’s a long time to be in pain and having trouble walking – so having Private Health Insurance can make a big difference.   

If you need a total or partial hip replacement and you have Hospital Cover that includes Joint Replacements cover, you’ll be able to schedule your surgery much faster. Not only that, you can select a private hospital and a surgeon of your choice, and you may even be able to get your own hospital room (if available). Depending on your policy and the doctor you choose, there may be an excess as well as a Gap for you to pay. In 2022-23, 85% of people who used Private Health Insurance for a hip replacement had to pay out-of-pocket costs, with the average cost being $4,800. 

What is a Gap?

What health insurance policies cover hip replacements? 

Hip replacements fall under the Joint Replacements Clinical Category of Hospital Cover, which is usually only available on Gold tier policies (although some insurers may choose to cover it on Bronze and Silver policies). While a Gold tier policy is the most expensive level of Hospital Cover, if you need a hip replacement that policy will really pay off, potentially saving you more than $33,000 (the average hospital fees for a hip replacement in a private hospital). Plus, doctor and specialist fees average $5,200 for a hip replacement, which is partially covered by Medicare and health insurance (plus a Gap for you to pay, if applicable).  

What are the Clinical Categories of Hospital Cover?

What are the tiers of Hospital Cover?

If you’re taking out Hospital Cover for the first time, or you’re upgrading to Gold cover from a lower tier, you’ll have to serve a 12-month waiting period before you can claim. Remember to check the policy terms and conditions carefully. 

If you have Extras Cover, you’ll also be covered for some of the physiotherapy or occupational therapy costs as part of your rehabilitation after surgery.  

What’s the best health insurance for hip replacements? 

The best health insurance policy is the one that best fits your budget and meets your healthcare needs (for a hip replacement and beyond). There are a lot of health insurance policies available, but other health insurance comparison websites won’t show you all your options. Here at healthslips.com.au we’re the only website that shows you every policy from every insurer, for free, and you don’t have to enter your contact details.  

Search for health insurance that covers hip replacements here.

Trudie McConnochie

Writer and Researcher

Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.

Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.

Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.

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