A Guide To Private Health Cover For Plastic Surgeries
There’s a variety of cosmetic and plastic surgeries available to Australians, with some being optional procedures and others being essential, such as reconstructive surgery following an accident.
Depending on the type of surgery, you may be entitled to a Medicare rebate. However, there are many surgeries that aren’t covered by the public health system.
This guide explores some of the most common cosmetic and plastic surgeries performed around the country, as well as whether you should take out private health insurance to reduce potential out-of-pocket expenses.
Key Points
Medicare doesn’t cover any expenses for elective cosmetic surgery.
Most private health funds don’t cover plastic and cosmetic surgeries, but they may cover some of the costs of surgery, such as hospital stays and theatre fees.
The cost of a tummy tuck can approach $30,000 in Australia, with Medicare only providing benefits if it’s deemed medically necessary.
What’s the difference between cosmetic and plastic surgery?
The two terms are often used interchangeably, however plastic surgery is the umbrella term under which cosmetic surgery falls.
While all plastic surgeons are cosmetic surgeons, not all cosmetic surgeons are plastic surgeons.
Cosmetic surgery generally refers to procedures that are performed purely to enhance or alter certain parts of your body. These elective treatments can include anything from face-lifts, to abdominal implants, to breast augmentations.
Cosmetic treatments are technically ‘plastic surgery’ as well, however the general practice of plastic surgery includes more medically necessary procedures, such as removing a tumour or fixing a congenital defect.
Is cosmetic surgery covered by Medicare?
Because cosmetic surgery is recognised as an elective procedure and one that is not essential to an individual’s health, Medicare does not provide benefits for these treatments.
This means you’ll likely need to cover the total cost of a non-medically necessary procedure yourself, unless you have private health insurance.
That is… most health funds in Australia won’t pay benefits for purely cosmetic surgery, nor for any costs associated with your hospital stay.
A policy will generally only cover these surgeries if they’re deemed medically necessary, so make sure you read the fine print before taking out health cover for your surgery.
How much does a tummy tuck cost and is it covered by Medicare?
The cost of this procedure depends on a variety of factors, but generally you can expect a tummy tuck (aka abdominoplasty) to cost anywhere between $9,000 and $29,000 in Australia*.
If the procedure is purely elective, you won’t get any cover from Medicare and, at best, you may only get some of your out-of-pocket hospital fees covered by your private health policy. They’re unlikely to cover the cost of the actual surgery.
In some instances, however, Medicare will reimburse you for the cost of a tummy tuck.
If such treatment is deemed medically necessary – such as for gut reconstructive purposes – then part of these expenses will be covered.
How much does liposuction cost?
Like most plastic surgeries, liposuction isn’t a cheap procedure. The total cost depends on how much fat you need removed, as well as whether there are multiple areas on your body where your liposuction will be performed.
Generally, the cost in Australia for liposuction can range from:
$3,000 – $5,000 for one area of the body.
$5,000 – $6,500 for two areas.
$6,500 – $8,000 for three areas.
$9,500 – $15,000 for four or more areas^.
This includes multiple expenses, such as fees for the surgeon, anaesthetist, any assistants, and your hospital and theatre costs.
Will Medicare cover a rhinoplasty?
Because the vast majority of nose surgeries are for aesthetic reasons, Medicare – and many private health funds – won’t cover the cost of rhinoplasty.
This is because in the Medicare Benefits Schedule, nose surgery falls under the ‘therapeutic procedures’ category.
However, if you have a serious medical condition that can only be rectified with a rhinoplasty, such as a condition that impairs your breathing or quality of life, then Medicare may partially cover the cost (up to 75%) of nose surgery**.
Can breast surgery be medically necessary?
Yes, in some cases breast surgery is medically required rather than purely for aesthetic purposes.
If surgery is deemed medically necessary by a certified surgeon, then Medicare may provide a rebate for treatment.
Having heavy breasts can cause a lot of chronic health problems, such as permanent back issues, which can only be rectified with corrective surgery.
Cosmetic breast surgery, however, isn’t medically necessary and is therefore not covered by Medicare, nor by most health funds.
Do I need plastic and reconstructive surgery as part of my health insurance policy?
While Medicare does pay benefits on certain plastic surgeries that are determined to be medically necessary, you’ll likely still have to cover out-of-pocket expenses, such as any costs incurred for the hospital stay and use of the theatre.
If you don’t have appropriate private health insurance, this makes any medically necessary plastic or reconstructive surgery even more expensive.
Make sure you do your research and compare health funds that cover these costs – in particular, choose the right tier of cover (e.g. plastic surgery benefits are often included in Gold tier cover) so you’re not left with thousands of dollars in bills without any support.
You can read more about Gold tier health cover in our guide here.
COMPARE & SAVEWhat are the waiting periods for cosmetic surgery?
Waiting times vary from health fund to health fund, but generally if the plastic or cosmetic surgery is purely elective then you will likely not be covered.
If the treatment is medically necessary and related to maternity services (obstetrics) or a pre-existing condition, you will have to wait out the 12-month period before getting coverage from your provider.
How do I find health cover that includes my plastic surgery?
If you’re planning to get medically necessary plastic or cosmetic surgery in future – or if you simply want to be covered in the unexpected event that you require this type of emergency surgery – then it’s worth taking out private health insurance.
Does having private cover mean I can choose my preferred surgeon?
Yes! Compare Club makes it easy to find great value private health policy for your needs, saving you time and money.
Simply enter a few helpful details and we’ll collect the most suitable policies from some of Australia’s top health funds`. You can then compare and switch, so you’re covered when it’s time to book your surgery.
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