SmallJoy Posted September 6, 2012 Report Share Posted September 6, 2012 Does top Private Health cover any of the breast augmentation costs? Like anaethesia, hospital costs or anything? Or can you claim anything back from Medicare? It might be a stupid answer but I have no idea!!! Thanks ladies Quote Link to comment Share on other sites More sharing options...
Platinum Posted September 6, 2012 Report Share Posted September 6, 2012 No it doesn't cover anything unfortunately. I was having a tummy tuck and a BA in the same op and it would have covered some of it plus I would get a Medicare rebate but only because of the tummy tuck. Because a BA us considered cosmetic then you can't claim anything unless there does happen to be a medical reason for it and then Medicare need to approve it. I am only having the BA now and the tummy tuck in a few years so have to pay it all. Quote Link to comment Share on other sites More sharing options...
Lizdexandivy Posted September 6, 2012 Report Share Posted September 6, 2012 Actually, it depends on why you're having the surgery - if you have breastfed and your youngest child is <6 (or 7 years, I've heard both), and it is reconstructive - like a lift with implants as I am having - your anaesthesia & hospital costs are covered (less the excess of course). With HCF, if it is reconstructive and has the medicare item number 45558, HCF will actually pay for the implants themselves. Theres also a possibility that some of it will be refundable from medicare! REALLY - nothing dodgy! Completely legit. My surgery quote was $10500, by the time HCF pay their share, it will have only cost me $7100, and I think there is still a potential $1600, further that I may get back from medicare. I almost feel guilty about it - but then I look at my boobs Quote Link to comment Share on other sites More sharing options...
Platinum Posted September 6, 2012 Report Share Posted September 6, 2012 Livdexandivy isn't that only for more severe cases? I have breast fed 2 kids and on top of that have tuberous breast deformity but my case is not severe enough for Medicare to approve it. A few ladies here have been approved by Medicare but it took months for approval and it was because the droop of their breast was at a certain position/degree. There is no harm in trying Medicare SmallJoy if you think you might qualify Quote Link to comment Share on other sites More sharing options...
Lizdexandivy Posted September 6, 2012 Report Share Posted September 6, 2012 Livdexandivy isn't that only for more severe cases? ... Mine are reasonably bad, I think part of the criteria is that the nipple line needs to be on or below the inframammary fold, so if a BA on its own will fix it, you're right, its probably not sever enough. I also have an awful loft of void space and no fullness in the upper pole of the breast so yeah, I guess mine are pretty bad. That said although I do consider them a definite deformity, I thought I was probably being a bit melodramatic. Until I said to the consultant: "actually, maybe mine don't need a reconstruction, maybe they just need some implants: and she replied something along the lines of "oh honey, they definitely need a lift" Quote Link to comment Share on other sites More sharing options...
Lizdexandivy Posted September 6, 2012 Report Share Posted September 6, 2012 But please, like Platinum said, discuss it with your healthfund and see what they say. I wasn't expecting to get any of it back, but the consultant called and told me to discuss it with HCF and it was a very pleasant surprise. Quote Link to comment Share on other sites More sharing options...
Lozz68 Posted September 6, 2012 Report Share Posted September 6, 2012 reported the stupid spam!! Yes i think it really depends on the severity of your case to whether you will qualify to be covered by medicare, and then whether your health fund will cover it! A PS should usually be able to tell you what your chances are for being approved, whether it be for tuberous or sagging breasts. I dont think i have heard of any approved just from sag before though. Quote Link to comment Share on other sites More sharing options...
SmallJoy Posted September 7, 2012 Author Report Share Posted September 7, 2012 No there's nothing wrong with my boobs, just want them bigger! It was just a question as I know they cover other elective surgeries and I thought no harm in asking! Thanks for all your help ladies. A wealth of information on here that would be difficult to obtain elsewhere. I appreciate it . Quote Link to comment Share on other sites More sharing options...
Platinum Posted September 7, 2012 Report Share Posted September 7, 2012 It is annoying that they don't cover it SmallJoy! If they did then the hospital fees would be covered which would be a big help. I am paying $2700 in hospital fees for day surgery Quote Link to comment Share on other sites More sharing options...
Lozz68 Posted September 7, 2012 Report Share Posted September 7, 2012 The good news is if something does go wrong after and you have complications with your BA it can be considered a reconstructive surgery i think and then are covered by medicare (and possibility private health!). just unfortunate this doesnt apply in the first place Quote Link to comment Share on other sites More sharing options...
1st timer Posted September 7, 2012 Report Share Posted September 7, 2012 Medicare approved mine for a lift but not implants due the age of my kids and the sag of my breasts. The board meets 3 times a year to discuss cases. Your surgeon will submit your paperwork for you. Once you have the approval letter and have your surgery Medicare will pay you back. Don't get excited it isn't much in the whole cost of things. If you have private hospital cover and qualify under Medicare they will cover that part of the surgery. I had implants as well and none of that was covered. Each case is judged individually. reported the stupid spam!! Yes i think it really depends on the severity of your case to whether you will qualify to be covered by medicare, and then whether your health fund will cover it! A PS should usually be able to tell you what your chances are for being approved, whether it be for tuberous or sagging breasts. I dont think i have heard of any approved just from sag before though. Quote Link to comment Share on other sites More sharing options...
Lizdexandivy Posted September 7, 2012 Report Share Posted September 7, 2012 Medicare approved mine for a lift but not implants due the age of my kids and the sag of my breasts. The board meets 3 times a year to discuss cases. Your surgeon will submit your paperwork for you. Once you have the approval letter and have your surgery Medicare will pay you back. Don't get excited it isn't much in the whole cost of things. If you have private hospital cover and qualify under Medicare they will cover that part of the surgery. I had implants as well and none of that was covered. Each case is judged individually. Hi 1st timer, Just wondering if you had private health insurance and how that works if you have to wait to get the approval from medicare down the track. Any further info you have would be most appreciated I'm not counting on getting anything from medicare - its not much anyway - you're right about that. But I wonder what that does to the subsidy from your health fund if medicare rejects things? Sorry If I hijacked your thread smalljoy, some women are lucky enough to only need a implants to fix thing, I posted just in case it helped Quote Link to comment Share on other sites More sharing options...
Platinum Posted September 7, 2012 Report Share Posted September 7, 2012 Livdexandivy, from what I have looked at but not from experience, if medicare are to approve you, then you get a rebate of just under $1000 back and your health fund would cover your hospital fees depending on your coverage, if you have an excess you would pay that. If medicare don't approve you then you just pay everything like any other patient would and not get a rebate from medicare or have have your hospital fees covered. When I was originally having the TT and BA in one op, my TT was covered but not the BA. I would have gotten a rebate of nearly $1000 and the hospital fees for the TT would be fully covered for the TT part but not the BA. Having the 2 together also reduced the hospital fee for the BA. So instead of paying $2700 in hospital fees for the BA, it would have come down to around $800 at one hospital my PS works out of, the other was still almost $2700 at another hospital so that is another thing to check out. From what I gather approval for a breast lift attracts the same sort of rebate and that only that part of the op is covered and the BA is not if you also have one in the same op. Quote Link to comment Share on other sites More sharing options...
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