How Much Will My Knee Replacement Cost?

What is knee replacement surgery? 

AlAlso called a knee arthroplasty, knee replacement surgery swaps your damaged knee joint with a synthetic one. This can help reduce your joint pain plus get some of your mobility back. 

This kind of joint replacement might be recommended for you if you have severe osteoarthritis or rheumatoid arthritis, avascular necrosis (that’s when a part of your bone  dies due to lack of blood supply), or other conditions that affects your comfort and mobility. Essentially, if other treatments and pain relief just aren’t up to the job, a knee replacement might be the way to get you moving again. 

Just like there are different reasons to get a knee replacement, there’s a few types of knee replacements too. These include: 

• Total knee replacement (all knee joint surfaces are replaced)
• partial  or unicompartmental knee replacement (part or parts of the knee are replaced)
• kneecap replacement or patellofemoral arthroplasty (this is a type of partial replacement) 

If you’ve already had a knee replacement but there are issues with it, like the synthetic joint wearing out, you can also have a revision of it. 

How much does knee replacement surgery cost? 

If you’re using the public system, Medicare can cover all of your in-hospital knee replacement surgery costs. Sounds great, right? Well, maybe. The main downside is the wait time, which is potentially longer than a year. 

Alternatively, you can use the private system and have your hospital cover take care of some of the bill. In 2022–23, 78% of patients who chose this route had out-of-pocket costs when it came to their specialist fees, with $880 being the typical cost.¹These are the amounts patients typically paid for these services, rounded to the nearest dollar. They do not include hospital payments such as excesses, co-payments or other payments. These fees may vary depending on your situation. Not all patients had out-of-pocket costs; those who didn’t aren’t included in these figures. Data retrieved July 2024. In addition to specialist fees, private hospital fees can be about $18,000 for a knee replacement, but your insurer may cover all or most of this too.²Medical Costs Finder – Knee replacement

Keep in mind that as there are a few different types of knee replacements, costs can vary. 

Helpful Tip:

While knee replacement surgery comes under a hospital policy that includes joint replacements, combining this with an extras policy which includes physiotherapy and mobility aids can really help with extra costs you may incur during your recovery. There are loads of different types of extras policies, and chatting to one of iSelect’s Comparison Experts can help you narrow down a policy that suits your needs.

Dr. Jill Gamberg

GP, Coach and Lifestyle Medicine Coach

What out-of-pocket costs could there be? 

Beyond a gap between what your specialist charges and how much your insurer covers for your surgery, you may have other out-of-pocket costs too.  

For instance, your policy will likely have an excess — an amount you need to pay before your insurer will start holding up their end of the deal.  

Your policy could also specify a co-payment for each day you’re in hospital. FYI: people tend to stay one to four days in hospital after knee surgery.  

While these costs may have you leaning towards going public, remember that a knee replacement is more than just a surgery. There could be a long recovery time — sometimes as long as 12 months. Having private health insurance could mean you put your best foot forward on your road to recovery. This could include your insurer covering at-home rehabilitation, visits to the physiotherapist and even helping cover some of the costs for any mobility aids.  

Unfortunately, Medicare is unlikely to cover you for these kinds of things. Your state government might have programs, like Queensland’s Medical Aids Subsidy Scheme. Schemes like this can provide funding for mobility aids, but you may not be eligible depending on your circumstances. Similarly, physiotherapy sessions are unlikely to be covered by Medicare.

Will I have to serve any waiting periods for a knee replacement through private health insurance?

The maximum period your insurer can make you wait before you can claim your knee replacement with them is either two or 12 months. Why the difference? Two months is for those without a pre-existing condition, while 12 months is for those with one. 

Remember, these waiting periods only apply when you first purchase your policy. Once they’re served, as long as you continue to hold your health insurance you’re all good, even if you switch between health insurers. 

This is in stark contrast to going through the public hospital system where, unfortunately, wait times to be seen for knee replacement surgery are extensive. In 2022–23, the median wait time was 308 days for knee replacement surgery. Worryingly, 37.3% of people were waiting more than a year for their surgery day and a further 10% were waiting longer than 18 months.³Australian Institute of Health and Welfare – Elective surgery waiting times 2022–23 data tables When you’re in pain or discomfort, this is a long time to wait and can impact your lifestyle, physical and mental health.

What level of private health insurance do I need to cover a knee replacement?  

As standard, all gold hospital policies include cover for a knee replacement. However, insurers can also choose to offer it as part of a lower tier, at their discretion.  Often you’ll find knee replacements on silver plus policies, but it’s always wise to review the policy document or speak with the insurer if you want to double check what’s what. 

Where can I find and compare private health insurance?  

If you feel like a knee replacement is in your future, or you just want to be prepared for whatever may happen with your health, buying or reviewing your health insurance could be a smart idea. Using iSelect, you can compare a range of health insurance policies from different insurers online or by speaking with one of our Health comparison experts on 1800 784 772. With our services, you could find a policy you like quickly and get back to enjoying life, knowing you’re looking after your health.