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Is spine surgery covered by insurance?

Is spine surgery covered by insurance?

yes, spine surgery Since it is a medically necessary procedure rather than a cosmetic surgery, it is covered by almost all insurances in India. If you suffer from severe back pain that cannot be addressed with medication or physical therapy, spinal surgery is the best option.

Spinal surgery and health insurance

There are certain criteria that all surgeries must meet for insurance coverage. Surgery should be “medically necessary”. In other words, it must either “save lives” or “improve health”. In other words, it must be a cure for a deadly disease. Either the problem should be resolved or the patient’s health and quality of life should be significantly improved. Cosmetic surgery is therefore excluded.

Spinal surgery can significantly improve a patient’s quality of life. Especially if you are bedridden due to severe pain or spinal degeneration. This is why most spine surgeries are covered by health insurance.

Today, in addition to conventional spine surgery, laser spine surgery and minimally invasive spine surgery are becoming more common. These advanced spine surgeries require small incisions, can be performed on an outpatient basis, and are usually covered by insurance day care surgery provisions.

Waiting period for spine surgery

The waiting period is the period during which a person can claim insurance. This waiting period is pre-determined starting from the start date of the policy period. The usual waiting period for spine surgery in India is 90 days. This means that if you have a new policy, you must wait at least 90 days before undergoing surgery to be covered by your insurance.

How much does spine surgery cost?

of spine surgery cost Range from Rupees. 1,40,000 rupees 2,40,000. This is an approximate cost range and will vary depending on several factors, including the type of spinal surgery you are having, your orthopedic doctor’s fees, the type of surgical procedure, the severity of your condition, and the hospital you choose to operate at. There are cases.Such

Other factors that affect the cost of spine surgery are:

  • Orthopedic doctor consultation fee
  • Medication during spine treatment
  • Types of spine surgery
  • Diagnostic tests for spine surgery
  • severity of condition
  • hospital selection
  • physical therapy after surgery
  • Length of hospital stay
  • Requires aids and medication

What types of spine surgery are there?

There are different types of spine surgery recommended by orthopedic surgeons based on the severity of the condition and the purpose of the surgery. Common minimally invasive spine surgeries include:

  • Spinal laminectomy or decompression It is commonly used in patients with spinal stenosis. The surgeon removes the osteophytes or walls that are compressing the spinal column to relieve pressure on the nerves.
  • Vertebroplasty/kyphosis It is used to treat compression fractures due to osteoporosis. The surgeon injects a glue-like bone cement that hardens and strengthens the vertebrae.
  • foraminotomy It is performed to widen the spinal column, where the nerve roots exit the spinal canal, when it has narrowed due to aging.
  • nucleoplasty too This procedure, called plasma disc decompression, is a minimally invasive laser procedure in which a surgeon uses a plasma laser machine to reduce disc size and treat minor disc herniations. The average cost of nucleoplasty in India may differ from the final cost based on doctor’s fees, selected hospital fees, etc.
  • in the meantime spinal fixation, The surgeon removes the intervertebral disc and uses bone grafts or metal implants to fuse the adjacent vertebrae together, allowing the vertebrae to fuse through the bone graft. For example, ACDF surgery (anterior cervical discectomy and fusion), TLIF surgery (transforaminal lumbar interbody fusion).
  • artificial disc replacement It is performed on people with severe damage to the intervertebral discs. A surgeon removes the disc and replaces it with a synthetic implant to restore height and motion to the vertebrae.
  • Discectomy (or microdiscectomy) A herniated disc surgery to remove a herniated disc that is compressing the nerve roots and spinal cord. It is often performed in conjunction with a laminectomy.

Which costs are usually covered by health insurance?

In general, all health insurance covers the costs of:

  • Accommodation expenses, lodging expenses, and nursing expenses incurred during surgery
  • ICU admission fee
  • Fees charged by doctors, surgeons, specialists, consultants and anesthesiologists during surgery
  • Operating room fee
  • Medical expenses such as anesthesia, blood, oxygen, prosthetics, and grafts required during surgery
  • Hospitalization expenses other than the above

In addition to this, all good policies also cover pre-hospital costs incurred between 30 and 60 days prior to surgery, including physical therapy and rehabilitation costs.


Although spine surgery is covered by insurance, patients with high deductibles may not be able to pay the rest out-of-pocket. In this case, the patient may have to spread themselves thin to cover the cost of the entire treatment, which is why some patients have free EMI surgery and are used only for medical expenses. Health care, a special credit card, relies on his credit card. On the other hand, patients with high insurance premiums may have no problem having adequate insurance coverage for their surgery.

orthopedic doctor pristine care With over 15 years of experience, he specializes in minimally invasive orthopedic surgery. Call us to book a free consultation with a local spine specialist. A medical coordinator can help. Is spine surgery covered by insurance?

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