Health Insurance For Cosmetic Surgery

Compare health insurance quotes which may cover cosmetic or plastic surgery through Savvy.

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, updated on July 6th, 2023       

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Australia’s Medicare system doesn't cover any of the costs of cosmetic surgeries carried out purely for aesthetic reasons. This means that private health insurance won’t cover such procedures either. However, there is plastic and reconstructive surgery which is medically required to either correct abnormalities or to reconstruct parts of the body that have been damaged through injury or necessary surgery.

You can compare health insurance policies covering medically-necessary cosmetic or plastic reconstructive surgery with Savvy. Our panel of trusted Australian insurers can provide free online quotes for you to compare in one place. Start the process of considering your available offers through us today.

What type of health insurance covers medically-necessary plastic and reconstructive surgery?

If you’re after a tummy tuck or would like your nose straightened, there are no private health insurance policies available in Australia which will cover their cost, as they aren’t considered medically necessary. Other types of cosmetic surgery which aren’t covered by private health insurance include:

However, many people require surgery to repair their bodies after devastating injuries, burns, accidents and surgery. Some babies are born with deformities that require reconstructive surgery to help them live a normal life, such as those born with a cleft palate. This is known as medically-necessary cosmetic or reconstructive surgery and may or may not involve plastic surgery.

There are health insurance policies which can assist such people with the cost of their surgery. These policies tend to be on the top tier of hospital cover and may offer cover for over 1,600 procedures which are listed under the Medicare Benefits Schedule as medically-necessary plastic or reconstructive surgery procedures.

Gold and silver hospital cover policies can assist with the cost of such surgeries. This is one area of clinical cover which all silver and gold hospital cover policies must offer under Private Health Legislation. This determines which clinical categories must be offered with each tier of health cover offered, so the Australian public has a clearer idea of what treatments are offered at each level of private health insurance cover.

What cosmetic or plastic surgery procedures can be covered by private health insurance?

There are many occasions where the human body is damaged, either at birth or through accident, injury, illness or surgery which is necessary to save a life. Such surgeries may include:

  • Surgery to repair congenital abnormalities such as cleft lips or palates or nasal deformities
  • Skin grafts and release of skin tightening following traumatic burns
  • Surgery to remove cancers or tumours (such as mastectomies to treat breast cancer)
  • Laceration and scar tissue repairs after limb injuries
  • Reconstruction following surgery, or acute vehicle or industrial accidents
  • Amputation and limb repairs

If you do have a silver, silver plus or gold hospital cover policy, you can be covered for some of the cost of plastic or reconstructive surgery. These can typically cover:

  • The cost of your stay in hospital, including in a private room if available
  • The cost of fees charged by your doctor, oncology specialist, surgeon or anaesthetist for consultations whilst you’re an in-patient
  • Theatre, recovery ward and room fees for your hospital stay
  • Allied health services provided whilst you’re in hospital, such as pain management, physiotherapy and remedial massage
  • Tests performed while you’re in hospital, such as blood tests, x-rays, MRI and CT scans
  • The cost of medicines and pharmaceuticals provide during your hospital stay

However, you may still have out-of-pocket expenses, such as an excess or co-payments you may be required to pay for your hospital stay. However, not all insurers and policies will come with a requirement to pay an excess or co-payment.

You can compare silver and gold hospital cover policies through Savvy. You’ll be able to see a variety of health policies side-by-side so you can compare their benefits and choose which one may best suit your current health needs.

How do I compare health insurance policies for cosmetic surgery?

These are some of the areas you should look at to help find a policy from our panel of trusted insurers which may cover medically-necessary plastic or reconstructive surgery:

  • Level of cover – make sure you're comparing similar silver or gold hospital cover policies when considering quotes. If you’re also looking at extras cover, this type of insurance may assist you with some non-hospital healthcare treatments you may need after your surgery, such as physiotherapy.
  • Excess and co-paymentsan excess is the amount you’ll have to pay as a contribution towards your hospital stay. It can range from zero to $750, with cheaper policies having a higher excess. A co-payment may also be required if you do have a hospital admission. This can range from zero to $100 a day, but there is often a cap placed on the co-payment you’ll be required to contribute.
  • What's available in your area – think about the health facilities that are available to you in your local area and whether having private health insurance will assist you in using those facilities.
  • Inclusions and exclusions – check that you’re aware of what is and isn’t covered when comparing policies. It pays to read the product information documents which are available for each policy, as they can detail what’s being offered with the policy and what’s excluded.

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Frequently asked questions about health insurance for cosmetic surgery

Is weight loss surgery considered cosmetic surgery?

Weight loss surgery has plenty of conditions attached when it comes to Medicare coverage. To qualify for bariatric surgery under Medicare (and therefore get assistance from your private health insurance) there are strict conditions which are applied, such as:

  • You must have a BMI over 35 or more
  • There must be medical documentation that you’ve been severely overweight for at least five years
  • You must have a co-morbidity which results in a major health risk, such as sleep apnoea, diabetes, heart disease, osteoarthritis or high blood pressure
  • There must be evidence that you have unsuccessfully tried other weight loss methods and programs under medical supervision
  • There must be no other cause for obesity such as adrenal, thyroid or pituitary gland issues
  • You must be assessed by a team of healthcare professionals
Who decides if my cosmetic surgery is medically necessary or not?

Reconstructive surgery can be a grey area when it comes to Medicare funding, as mental health considerations come into play. Your doctor is best placed to make this decision. 

Is liposuction covered by private health insurance?

No – liposuction is considered to be purely cosmetic surgery with no medically necessary reasons to carry out the procedure, so it isn’t covered by Medicare and therefore won’t be covered by private health insurance either.

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