Private Health Insurance For Tummy Tuck

Compare quotes for private health insurance that covers medically necessary tummy tucks through Savvy. 

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, updated on July 6th, 2023       

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We’ve partnered with Compare Club to bring you a range of health insurance policies to help you compare them side by side.

Considering a tummy tuck in Australia? While Medicare doesn’t cover tummy tucks unless they’re medically necessary, private health insurance may provide some coverage for the procedure as part of a hospital policy if your doctor considers the surgery is required on medical grounds. 

You can compare health insurance policies and find out about the benefits of private health insurance for tummy tucks in Australia through Savvy. Discover what to look for in a policy and how to find the right health insurance coverage for your medically-necessary surgery. Get started with the comparison process through us today.  

What type of health insurance covers tummy tucks in Australia?

Cosmetic surgery isn’t covered by private health insurance in Australia. This means if you want a tummy tuck (abdominoplasty) or a facelift for cosmetic reasons, your private health insurance won’t cover any of the costs associated with the surgery. 

However, the Medicare Benefits Schedule does include item numbers for tummy tucks in certain situations, which means that Medicare may cover some of the costs of your surgery if a tummy tuck is deemed to be medically necessary. If this is the case, having private health insurance hospital cover can assist you with the cost of the surgery.  

To be considered medically necessary and eligible for a tummy tuck partially financed through Medicare, patients must meet some or all of the following requirements: 

  • Loss of a minimum of five body mass index (BMI) points, with stable weight loss and reduction for at least six months 
  • Suffering from intertrigo (skin rubbing on skin) which has failed to be resolved after at least three months of other conservative treatments (such as using creams) 
  • Having excess redundant skin which interferes with normal life 
  • Suffering a separation or tear of abdominal muscles 
  • Other abdominal muscle injuries and tears

Tummy tucks which are considered medically necessary may be performed if you suffer from any of the following conditions: 

  • Separation of the large abdominal muscles following pregnancy (rectus diastasis) 
  • Multiple pregnancy disfigurement 
  • Excess skin and fat following radical weight loss 
  • Abdominal hernias 
  • Weight-lifting injuries resulting in stretched abdominal muscles 

How can private health insurance assist with the cost of a tummy tuck?

Private health hospital cover can assist you with the costs of:  

  • private hospital admission costs and private room fees if applicable  
  • the expenses related to surgery such as theatre charges 
  • consultations with doctors, anaesthetists and other specialists in hospital 
  • in-patient tests such as CT scans, blood tests, and X-rays 
  • allied health services, including post-operative pain management  

Hospital cover is available in four levels: basic, bronze, silver and gold. The level of insurance you'll require to cover part of your tummy tuck will generally be a gold policy, although some insurers may offer coverage under silver plus hospital insurance. It's important to carefully review the terms and conditions of your specific policy to determine the level of hospital cover required for coverage of a tummy tuck. 

You can compare health insurance policies which may cover abdominoplasty through Savvy. All you need to do to get the process started is answer a few simple questions about the cover you're looking for and you can see the policies which fit your requirements from our panel of leading health insurance providers.  

What should I look for in a private health insurance policy that covers tummy tucks?

If you're comparing private health insurance policies which cover abdominoplasty or tummy tucks, there are several things to look at to help you get the coverage you need: 

  • Cost – while it may be tempting to go for the cheapest hospital cover policy, make sure the policy you buy offers the cover you need for skin surgery which would include a medically-necessary tummy tuck 
  • Compare apples with apples – make sure you’re comparing policies with the same tier of cover, such as a silver policy with another silver policy 
  • Waiting periods – review the policy documents carefully to understand the waiting period which may apply, particularly if you're increasing your level of private health hospital cover or are having treatment for a pre-existing condition 
  • Excess level – you can choose between policies which have an excess ranging from zero up to $750. The higher the excess you choose, the less your monthly premiums are likely to be, but the more you’ll have to pay in out-of-pocket expenses when you're admitted to hospital for your surgery 
  • Co-payments – check if there are any co-payments required when you're admitted to hospital 
  • Claim limits – check and compare what limits may apply to the policy overall, and in any one particular financial year 

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Frequently asked questions about private health insurance for tummy tucks

What are the average waiting periods that apply before a claim can be made for a tummy tuck?

Most private health insurance policies have a waiting period of 12 months for a tummy tuck. This is because they're generally considered a pre-existing condition, which come with required 12-month waiting periods.

What is the difference between full and partial abdominoplasty operations?

The main difference between a full and partial abdominoplasty is the extent of the procedure. A full abdominoplasty, usually known as a tummy tuck, involves removing excess skin and fat from the entire abdomen, while a partial abdominoplasty, or mini tummy tuck, addresses only the lower part of the abdomen below the navel. 

Can I avoid public hospital waiting lists and get my tummy tuck done sooner if I have private health insurance?

Yes – having private health insurance may assist you to avoid public hospital waiting lists for elective surgery, which can be two years or more in some states of Australia. The time you’ll have to wait for your surgery will depend on the private health facilities available and surgeons who operate in your specific area. 

Are there any exclusions to private health insurance coverage of tummy tucks?

Yes, some private health insurance policies may have exclusions or restrictions on coverage for tummy tucks. It's important to review the policy documents carefully to understand any limitations on coverage.

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