Who needs joint replacement surgery?

According to the Australian Institute of Health and Welfare (AIHW), the most common age group for musculoskeletal surgery is 55 to 64. So if you're young and fit, you may think you don't need cover for joint replacement. Truth is though, anyone can be affected by painful joints, especially if you play a lot of sport or live an active lifestyle. 

What's the difference between total and partial joint replacement surgery?

A total joint replacement involves a damaged joint being surgically removed and replaced with a new prosthetic (artificial) joint which has been designed to move just like regular joints. 

A partial joint replacement refers to a surgery which involves using prosthetics to fix only the damaged parts of a joint.

What's the difference a joint replacement and a joint reconstruction?

A joint reconstruction aims to repair damaged joints in order to offer temporary or permanent pain relief for joint disorders - for example, an Anterior Cruciate Ligament (ACL) injury such as a tear or sprain. The treatment you receive will depend on the type and severity of the joint disorder. Some common reconstructive surgeries include arthroscopy, arthrodesis, osteotomy, resurfacing and small joint surgery.

Do hospital waiting periods apply?

Whether we’re answering your call, or helping you switch from another health fund, we don’t like to keep people waiting. But unfortunately waiting periods (the time you have to wait before you can claim for treatment) are a necessity. We wouldn't be able to offer our affordable premiums and generous benefits without them.

Waiting periods exist so we can protect our members against people who simply join us, claim large amounts and then leave. But we always try to keep waiting periods to an absolute minimum. That’s why, if you join us from another health fund, we’ll take your previous membership into account, so you won’t have to re-serve waiting periods on an equivalent level or lower level of health cover.

For HIF Hospital cover, the waiting periods are as follows:

  • 2 months: General hospitalisation
  • 2 months: Psychiatric care, rehabilitation & palliative care (regardless of whether it's pre-existing or not)
  • 12 months: All pregnancy and birth related services
  • 12 months: Pre-existing conditions or ailments

Will a pre-existing condition affect my cover?

The Pre-Existing Condition waiting period applies to new members and existing members who upgrade their policy to access higher-level benefits. The test applied under the law relies on the presence of signs or symptoms of the illness, ailment or condition, not on a diagnosis (i.e. it’s not necessary for the member or their doctor to know what their condition is or for it to be diagnosed).

In forming an opinion about whether or not an illness is a pre-existing condition, an HIF-appointed medical practitioner will take into account information provided by the member’s treating doctor.

A pre-existing condition is defined as: ‘Any ailment, illness, or condition where, in the opinion of a medical adviser appointed by the health insurer, the signs or symptoms of that illness, ailment or condition existed at any time in the period of six months ending on the day on which the person became insured under the policy.’

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