Home >  Blog >  Is Plastic Surgery covered by my private health insurance?

Is Plastic Surgery covered by my private health insurance?

Posted by Dr Lily Vrtik on 23 August 2021

Plastic Surgery procedures are divided into two main categories reconstructive and cosmetic. Many of the procedures we perform are rebatable from Private Health Insurers (PHI) as they are performed for medical reasons. However, each procedure can only be claimable if certain criteria set by the Medicare board are met. This is why a preoperative appointment is essential for us to provide you with an accurate quote for your procedure, as it is during your consultation that you will have a thorough clinical assessment to determine if your condition meets the criteria to make your procedure rebatable.


What procedures may be rebatable? Here are a few examples:
Breast Reduction, Breast Reconstruction, Blepharoplasty (eyelid lifts),and Abdominoplasty(Tummy Tuck).


It is up to you to check with your PHI whether you are covered for these particular items, as some PHI has cheaper policies with specific exclusions such as all plastic surgery, or plastic surgery item numbers. If so, this will not only mean that you are not covered for any of the procedures mentioned above, but also all plastic surgical procedures such as surgery to reconstruct defects after excision of skin cancers, after breast cancer surgery, or even after a traumatic accident whether it will be procedures to rebuild your face, your leg or even your hands and arms.


Cosmetic procedures (or Aesthetic Plastic Surgery), such as facelifts, liposuction, breast augmentation, to name a few, attracts no rebate from either Medicare or your PHI. Thus, for any cosmetic surgery, you will have to pay a surgeon's fee (of which we will provide you a quote after your consultations), anaesthetic fee (if you require an anaesthetist), and a hospital fee (the amount of which is dependent on the type of procedure and the number of days in hospital).


To find out more about our Fee Structure, click here.

Dr Lily VrtikAuthor:Dr Lily Vrtik
About: Dr Lily Vrtik is a fully-qualified and accredited aesthetic, plastic & reconstructive surgeon practising in Brisbane, Queensland (QLD), Australia.
Tags:plastic surgery

Consults at

Everton Park

Suite J, Lower Level
North West Private Hospital
137 Flockton Street
Everton Park QLD 4053

Click here for google map location
Sunnybank

Australis Specialist Centre
Suite 1, 679 Beenleigh Road
Sunnybank QLD 4109

Click here for google map location

Contact details

Post - PO Box 5301 Stafford Heights QLD 4053