What you need to know about health insurance and cosmetic surgery

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If someone says the words “cosmetic surgery”, what tends to come to mind is nose jobs and liposuction. However, what many people don’t know is that there are many types of necessary procedures that fall under the cosmetic bracket. Whether reparative (such as in the case of an extreme injury or burn) or preventative (post-mastectomy reconstructions), these operations are often medically necessary, but they can still be expensive.

How is it defined?

Firstly, reconstructive plastic surgery is usually the phrase used to describe medical procedures that are completely essential and not elective. These procedures are typically performed with the purpose of correcting congenital or acquired abnormalities or repairing trauma-caused damage.

How much does it cost?

It’s important for people to know and understand the costs involved before committing to any kind of medical procedure, even if it’s just day surgery. What’s concerning is that so many Australians think that surgery in Australia is so unaffordable that they seek medical treatment overseas. While cosmetic surgery can be extremely costly, what many Aussies don’t know is that there is a range of surgeries that are eligible for a rebate under both Medicare and the private health system.

What can you claim on your private health insurance?

If you have comprehensive hospital cover, any medically necessary procedure you undergo should leave you eligible for reimbursement. These can include:

  • Surgeries to correct congenital abnormalities. This typically refers to conditions that you’ve had since birth.
  • Burn-related procedures. Scar treatment, skin grafts and the reduction of skin tightening are all covered under private health insurance.
  • Traumatic injuries. If you’ve been in an accident that has caused significant physical damage and surgery is medically required (for example, facial bone fractures) you should receive reimbursement.
  • Surgery that follows cancer or tumour treatment. This can include reconstructive surgery following a mastectomy, or skin treatments following tumour removal.
  • Scar repair.

How can you get the best value?

If you already have private health insurance or you’re taking out a new policy, don’t be too quick to remove cosmetic surgery cover from your package. It’s something that may cross your mind later and you might wish you left it included. On the other hand, if you’re considering surgery while reviewing your health insurance policy, think about whether you’ll have to serve out a waiting period. If your surgery is elective and not deemed to be medically urgent, there may be more value in waiting than having the procedure done as soon as possible.

What about Medicare?

Unfortunately there are more than 1,600 items and procedures listed on the Medicare Benefits Schedule where you will be unable to receive full coverage. Generally if a procedure is medically necessary or required as part of a treatment for a bigger issue, Medicare should cover various aspects, such as operating theatre costs in public hospitals, required surgical consultations and the actual surgery. You can visit the ombudsman’s website to find out more information.

There is a huge range of cosmetic surgeries that are looking to dominate in 2017. As long as you know the ins and outs of the costs involved, you shouldn’t have a problem.

bessieBessie Hassan is an Insurance Expert at finder.com.au, Australia’s most visited comparison website.

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