Shoulder replacement surgery

Learn about the surgical procedure, costs and recovery for shoulder replacement.

What is shoulder replacement?1

Shoulder replacement is a type of surgery in which a damaged shoulder joint is replaced with an artificial one.

Shoulder replacement is usually recommended to treat severe pain or disability.

Someone who needs a shoulder replacement with shoulder pain

Signs you might need shoulder replacement2

Shoulder replacements are usually only considered if lifestyle changes, self-management techniques, medicines and other treatments like physiotherapy are not helping.

Here are some signs that your shoulder may need some kind of treatment:

  • Severe joint damage from osteoarthritis or rheumatoid arthritis
  • Moderate or severe shoulder pain while resting
  • Shoulder pain that doesn’t improve with rest or medications
  • Recurring or frequent dislocations
  • Rotator cuff tears

Alternatives to shoulder replacement3

  • Exercise-based rehabilitation2
  • Physiotherapy
  • Medicines
  • Steroid injections into shoulder
Man swimming to manage his shoulder pain
Woman with arm in sling recovering from shoulder replacement surgery

Shoulder replacement recovery3

Most patients leave hospital two to three days after shoulder replacement surgery.

For a few weeks following surgery, you will need to keep your arm in a sling.

Seeing a physiotherapist and doing the recommended rehabilitation exercises can help speed up recovery.

Private health insurance can help with physiotherapy costs too, if you get extras cover that includes physiotherapy. 

Getting a shoulder replacement at a public vs private hospital

It’s important to understand how getting your procedure in a public or private hospital differs.

Public system (Without health insurance)
Private system (With health insurance)

Will I avoid public hospital waiting lists?

  • No.
  • Yes.

Will I be able to choose my hospital?

  • No.
  • Yes.

Will I be able to choose my doctor or surgeon?

  • No.
  • Yes.

Will I have out-of-pocket costs?

  • No.
  • Yes.

What is the cost of shoulder replacement surgery?

In a public hospital

In a public hospital, shoulder replacement surgery is covered by Medicare for eligible residents.

Once you are discharged from hospital, you may still need to pay out-of-pocket for things like medicines and physiotherapy.

In a private hospital, using health insurance

In a private hospital, private health insurance can cover some costs of shoulder replacement surgery.

You may have an out-of-pocket cost if you use private hospital cover when you get treatment. You can minimise some of these costs by choosing a hospital and specialist that have agreements with your health insurer.

If you have an excess on your cover, you will have to pay for that out of pocket.

What is hospital excess?

What is an out-of-pocket cost?

How to find health cover for shoulder replacement surgery

Minimise your costs

Ask your GP for an open referral

Your GP is the one who’ll most likely refer you to a specialist – but they may not recommend the specialist you’d want to perform your surgery. Asking for an open referral can let you:

  • Choose your own specialist.
  • Find a specialist with good availability who can perform treatment at the hospital you prefer.
  • Find a specialist that you trust to perform your surgery.
  • Find a specialist with minimum out-of-pocket expenses for you.

Find an orthopaedic surgeon with minimum out-of-pocket costs

To find orthopaedic surgeons who work with HBF, just search for ‘orthopaedic surgeon’ in our find a provider tool.

  • Look for the “Full Cover” tick mark or “Access Gap Cover” tick mark.
  • These specialists will help minimise your out-of-pocket cost.

Find a Provider

If you’ve already started working with a specialist

If you’ve already got a specialist, ask them these questions:

  • Do you have a Full Cover or No Gap agreement with HBF?
    If they don’t, you may need to consider if their fees work with your budget.
  • What hospital(s) do you operate in?
    You can then check if the hospital has a Full Cover or No Gap agreement with HBF.

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