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Is Plastic Surgery covered by my private health insurance?

Posted by Dr Lily Vrtik on 25 August 2017

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 Implant Revisions, Breast Reconstruction, Blepharoplasty (eyelid lifts), Labioplasty, 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 means that you are not be 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.

Author: 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

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