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Long story short

Joint replacements and reconstructions can make daily life easier

These surgeries help treat arthritis, sports injuries and other musculoskeletal issues that cause mobility issues or regular pain.

Surgery costs vary depending on the type of surgery and joint

In the public system, surgery is free, but you might have to wait longer. Private patients can have out-of-pocket costs but usually a shorter wait.

An extras policy might cover some of your rehab costs

Seeing a physio or occupational therapist can be an important step to making a full recovery after a joint reconstruction or replacement.

What is joint replacement and reconstruction surgery?

A joint reconstruction is a procedure to mend your joint, while joint replacement surgery replaces the joint with a synthetic option. These surgeries aim to give you back your range of movement and reduce joint pain. Orthopaedic surgeons handle both kinds of surgeries (and sometimes call reconstructions ‘arthroscopies’, depending on the complexity and method of treatment).

The human body has lots of joints – unlike most action figures or Barbies – however, common joint reconstruction and replacement procedures centre on the hips, knees, shoulders and ankles.

If you’re sick of hip pain or knee pain, or your stiff joints mean everyday tasks are extra tricky, replacement or reconstruction surgeries might be a solution. They’re popular treatments for a range of conditions, including arthritis, osteoarthritis, sports injuries and musculoskeletal trauma. Keep in mind, though, that you’ll need to be a good candidate for the procedure. This includes how old you are – reconstructions are usually only an option for younger, active folks.

Is joint replacement surgery covered under private health insurance?

Joint replacement surgeries are covered by hospital insurance policies that include the joint replacements clinical category. Similarly, joint reconstructions are included on hospital cover with the joint reconstruction clinical category.

All gold tier hospital policies must include cover for joint replacements. However, you could find cover for joint replacement surgery on plus policies for lower hospital insurance tiers, like silver plus. It depends on what a health fund wants to offer.

How much do joint replacement and reconstruction surgeries cost?

The out-of-pocket costs for joint replacement surgeries for private patients in private hospitals ranged from $1,180 to $2,366 on average in the 2024–25 financial year, while knee reconstruction out-of-pocket costs were $1,942 on average, according to the Department of Health, Disability and Ageing. These costs don’t include hospital fees, like for the operating theatre or accommodation. Public patients don’t have out-of-pocket costs as Medicare handles the bill.

Unfortunately, joint surgery isn’t quite like a Maccas menu with set prices you can easily look up. Think of it more like a tailored gourmet experience, since your unique situation makes a big impact. Factors at play include:

• which joint is affected
• whether it’s a reconstruction or a replacement
• whether it’s a minorly or majorly complex procedure
• whether you’re a public or private patient.

As you can imagine, more complicated surgery usually comes with a higher price tag. Just like you, surgeons and anaesthetists expect to be paid extra for a more difficult job. At the same time, it’s worth knowing that a reconstruction can be a less involved – so potentially less costly – procedure than a replacement. After all, with this surgery, you get to keep your original joint.

Note: These figures reflect indicative medical costs for joint reconstructions and replacements in Australia as a private patient in a private hospital, based on Department of Health, Disability and Ageing data, and rounded where appropriate. Actual costs may vary depending on your required treatment, doctor, hospital, insurer and other unique circumstances. Based on data from July 2024 to June 2025 and retrieved September 2026.

Are there other out-of-pocket costs for joint replacement and reconstruction surgeries?

Other out-of-pocket costs for private patients having joint surgery include excesses, co-payments and hospital costs. Whether these costs apply to you depends on your policy and circumstances.

For instance, your hospital insurance might list an excess. This is a fee paid when you’re admitted to hospital. Like other types of insurance, your excess will be listed in your policy documents and is something you pick ahead of time.

Similarly, you could have a co-payment. This fee is paid for each day you’re in hospital. Thankfully, joint reconstructions tend to be same-day discharge affairs or only require a day or so in hospital. Some kinds of joint replacements can mean a slightly longer stay, but not much longer. So, if you do have a co-payment listed in your policy, chances are you won’t have to pay it too many times over for these kinds of surgeries.

Hospital costs cover things like accommodation and operating theatre fees. If your insurer has an agreement with your hospital, they’ll help cover some of the hospital costs, but you could still have out-of-pocket expenses. For instance, while insurers, on average, paid the bulk of hospital costs for joint replacements in 2024–25 financial year, according to the Department of Health, Disability and Ageing, the average private patient out-of-pocket cost ranged from $439 to $1,219.

Note: These figures reflect indicative hospital costs for joint reconstructions and replacements in Australia as a private patient in a private hospital, based on Department of Health, Disability and Ageing data, and rounded where appropriate. Actual costs may vary depending on your required treatment, hospital, insurer and other unique circumstances. Based on data from July 2024 to June 2025 and retrieved September 2026.

Are there costs after joint replacement and reconstruction surgeries?

There are costs after a joint replacement and reconstruction surgery, including for follow-up appointments and rehabilitation. Depending on the success of the surgery and your circumstances, you might also need further surgery.

After your surgery, you’ll have a follow-up appointment with your treating specialist. This is a chance for them to check in on how you’re travelling and whether you need any further help. Private health insurance can’t cover out-of-hospital specialist fees, unfortunately.

Mobilisation and rehabilitation therapy after your surgery is important to get you up and moving again sooner. You might need to see a physiotherapist, occupational therapist, exercise physiologist or a combination of these allied health professionals regularly for a while. As part of this, you might also need to pay for mobility aids to help you stay as independent as possible. With these kinds of costs, your extras cover might pay some of the bill, making it easier to give recovery your best shot.

And while we’re talking future costs, it’s worth mentioning that a further joint surgery could be in your future. Joint reconstructions can help stabilise your joint, but they might only delay the need for a joint replacement. Similarly, joint replacements, when well cared for, can last for around a decade. But then they can become too worn out and another replacement (and surgery) can be needed. Replacing a replacement is known as a revision.

Helpful tip

No one knows what the future holds, but if you really want to try and predict whether a joint surgery is in your future, there are a couple of things you can consider.

First, has anyone in your family ever needed one? Lots of health conditions can be inherited from family members. Your genes might come with a tendency for arthritis or another musculoskeletal condition.

Similarly, have you played lots of fast-paced sport that involves body contact or quick stops and fast turns? These kinds of movements can put stress on your joints, particularly if you don’t stretch or give them time to recover.

Andres Gutierrez

General Manager – Health

How long will I have to wait for joint replacement or reconstruction surgery?

Public patients had a median wait of 89 days for orthopaedic surgery, including joint replacements and reconstructions, while private orthopaedic patients at public hospitals only had a median wait of 39 days in the 2024–25 financial year, according to the Australian Institute of Health and Welfare. Your wait time will depend on your unique circumstances, like the doctor you’re seeing and their availability.

So, using your hospital cover to go private might be your ticket to skipping the public queue. After all, when you’re not feeling your best, patience tends to be in short supply.

If you do go the private system route, keep in mind any waiting periods attached to your policy. As a general rule, new policies come with a maximum waiting period of 2 months for joint replacements and reconstructions. The exception is pre-existing conditions. Then you’ll have a maximum wait of 12 months.

What level of health insurance do I need to cover joint replacement and reconstruction surgeries?

Hospital insurance policies at bronze tier and above must include joint reconstructions, while joint replacements are only guaranteed on gold cover. You might see them offered on some lower tier policies, such as silver plus, but this will depend on the insurer since it isn’t compulsory. Similarly, you might find joint reconstructions on some basic plus policies but this cover can be restricted.

How do I choose health insurance for joint replacements and reconstructions?

When choosing health insurance for joint replacements and reconstructions, compare each policy by premium, inclusions and exclusions, gaps, other out-of-pocket costs and waiting periods. This can include hospital cover for your surgery and extras cover for additional care, like physiotherapy after your surgery.

Everyone has different preferences for what they want out of a health insurance policy, but to help get a better understanding of whether a policy offers you value for money, review:

• policy premiums, aiming to balance cover with your budget
• inclusions, including hospital services and extras services that could support you before and after your surgery
• exclusions, so you aren’t paying for cover you won’t use
• benefits, including any agreements with nearby private hospitals or doctors you’d like to be treated by
• out-of-pocket costs, including excesses and co-payments
• waiting periods, particularly for extras cover, as shorter waiting periods for things like physiotherapy could help you manage your condition while you wait for your surgery.

Where can I find and compare health insurance?

It’s no secret that finding health insurance can be tricky and time-consuming, but iSelect is here to help. Using our online comparison tool, you can check out a range of policies, including those with joint surgery cover, from our range of providers in a matter of minutes. You can also call one of our health insurance comparison experts on 1800 784 772 if you’d prefer.