Knee arthroscopy cost

If you have knee pain, your doctor may recommend other treatments before trying a surgical procedure.¹ Physiotherapy or inflammatory medication (ibuprofen, etc.) may help manage pain and delay the need for surgery. When physical therapy and pain relief medication are no longer efficient, surgery will be considered.

Depending on your knee problem, an MRI may be able to diagnose the problem or potentially rule out anything that would require keyhole surgery. If you need treatment, you still may need an arthroscopy.

Private hospital cover can contribute towards a knee arthroscopy, providing you have the right level of cover. Your policy will need to include the clinical categories ‘joint reconstruction’ and ‘bone, joint and muscle’, which are minimum requirements for Bronze, Silver, and Gold tier hospital cover

Private health insurance allows you to be treated as a private patient in a private hospital, which has the following benefits:

• Avoid public hospital waiting times
• Choice of specialist and healthcare facility
• Private room (subject to availability).

Keep in mind that with any procedure, there may be a ‘gap’ between the MBS fee and the specialist fee. Depending on your policy, you may have to pay out-of-pocket for some or all of this gap payment.

Medicare will cover the costs of a knee arthroscopy performed as a public patient in a public hospital and some of the MBS fee if you’re treated in as a private patient. Your insurer will cover the remaining fee amount, if you have the right cover.

While public hospitals provide a valuable service, there are some downsides. Due to high demand, the public system has a long waiting list, which could lead to you waiting months for your treatment. You’ll also have little say over where your procedure is performed and when.

If you’re taking out health insurance for the first time, you may have to serve a waiting period before you can make a claim. These waiting periods can also apply if you’re upgrading your policy and want to claim on an inclusion you didn’t previously have. Joint reconstruction and bone, joint and muscle typically have a waiting period of two months. If you’re considered to have a pre-existing condition, the waiting period will be 12 months.

If you switch policies but have already served your waiting period for joint reconstruction and bone, joint and muscle, you won’t have to serve it again.