Medicare changes to abdominoplasty

By January 15, 2024 October 30th, 2017 News, Procedures
Medicare Rebate

Information for Patients Considering Abdominoplasty or Body Contouring Surgery

As of January 1 2016, access to abdominoplasty (tummy tuck) surgery for women with health issues as a result of pregnancies has been made significantly more difficult.

The Federal Minister for Health, Sussan Ley MP announced just before Christmas that many mums will no longer be eligible for a tummy tuck Medicare number.

The impact of this decision is that in many cases, Medicare rebates will no longer be available. For those patients with private health insurance, that means that fund rebates will also no longer contribute to the hospital fees, thus making the procedures for post pregnancy patients effectively classified as cosmetic. Essentially, many abdominoplasty and body contouring procedures will now not be covered by any form of private health insurance or Medicare.

The new rules are that abdominoplasty and body contouring item numbers (and thus Medicare and private health fund rebates) will only be eligible for patients who satisfy the following conditions:

  • Documented skin conditions including rashes as a result of the excessive skin unresponsive to medical treatment.
  • Documented interference with daily activities/life as a direct result of the extra skin/fat.
  • Patients weight must have been stable for at least 6 months following significant weight loss prior the surgery.
  • More than 5 BMI points must have been lost.

Medicare and private health insurance rebates are therefore still available for massive weight loss patients who suffer skin irritation and other issues associated with excess tissue and skin, who meet these conditions.

PSF would like to thank Arc Plastic Surgery for their input into this blog post.

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