Arthritis affects nearly 60 million Indians, yet fewer than one in ten undergo joint replacement surgery. And for those who do, the most advanced option, that is, robotic-assisted joint replacement, remains out of reach for many, because of a lack of affordability.
At a recent discussion hosted by the Partnership to Fight Chronic Disease (PFCD) in Mumbai, leading orthopaedic surgeons raised concern over the absence of equitable insurance coverage for robotic joint replacement surgeries. They argued that despite being globally recognised as the gold standard for precision and recovery, robotic-assisted procedures are still treated as 'optional' or 'luxury' add-ons by insurers in India.
“Robotic joint replacement is no longer experimental,” said Dr Milind Patil, Orthopaedic Surgeon at Revival Bone & Joint Hospital. “It’s an established technology with over 20 years of clinical use, adopted across 45 countries with over 1.5 million procedures performed globally. Yet in India, patients are forced to delay surgery simply because insurance doesn’t fully support it.”
According to Dr Patil, projections indicate that by 2030, nearly 70 per cent of such surgeries in the U.S. will be robotic. But in India, the absence of standardised coverage has meant that even those who can afford the technology hesitate to proceed.
What is a robotic joint replacement procedure?
It involves the use of computer-guided precision to map and execute the surgery, offering faster recovery, fewer complications, and reduced need for revision surgeries, explained doctors present at the conference. Patients also experience improved joint alignment and function, leading to longer implant life and quicker return to mobility.
However, the fact that robotic surgery is about 20 to 30 per cent higher than conventional surgery makes it a difficult choice for many if insurance companies refuse to reimburse the cost.
“Patients shouldn’t have to choose between ‘better care’ and ‘insurance support’,” said Dr Mudit Khanna, consultant joint replacement surgeon at Wockhardt hospital in suburban Mumbai. “If a patient is willing to bear part of the cost for advanced technology, they should still get proportional insurance coverage. Everyone deserves access to the best possible treatment without being penalized for it.”
The money talk
Experts argue that insurers often focus only on immediate surgical costs, overlooking long-term savings from reduced complications and readmissions. Prof Dr Pradeep Bhosale, Principal Director of Robotic Joint Replacement at Nanavati Max Hospital, said that robotic procedures actually save money in the long run.
“Revision surgeries when an implant fails can cost up to six times more than the original surgery,” he explained. “Robotics improves precision and reduces such failures. Insurers need to look beyond short-term costs and appreciate the broader healthcare impact.”
In 2019, the Insurance Regulatory and Development Authority of India (IRDAI) urged insurers to include modern treatments in their offerings, but implementation has been patchy. Coverage still varies widely across plans, with caps and exclusions preventing patients from opting for advanced care.
“Insurance policies must recognise robotic joint replacement as a medically necessary innovation,” said Aman Gupta, Asia representative for PFCD.
India’s healthcare ecosystem has been quick to adopt robotic technology, but policy and coverage frameworks haven’t kept pace. For a country where chronic diseases and arthritis are on the rise, experts say this mismatch will further widen the gap between the haves and have-nots. “Robotics represents progress, but without equitable insurance, it remains a privilege instead of a right," noted Dr Khanna.