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Health Insurance For Cosmetic Surgery
In this page, we’ll look at Health Insurance for cosmetic surgery, including what types of surgeries may be covered by your Health Insurance policy, and whether you can choose a policy that covers plastic surgery.
Is cosmetic surgery covered by Medicare?
As cosmetic surgery treatments aren’t medically necessary, there are no Medicare benefits available for cosmetic surgery.1Commonwealth Ombudsman – What is Plastic and Reconstructive surgery?
Frequently Asked Questions
What’s the difference between cosmetic and plastic surgery?
While there is no specific health insurance product for cosmetic surgery, some forms of plastic surgery are covered under private health insurance, depending on your policy.
To begin with it’s important to understand that cosmetic surgery and plastic surgery are not the same thing, even though many of us use these terms interchangeably.
Cosmetic surgery is just one aspect of plastic surgery.1Commonwealth Ombudsman – What is Plastic and Reconstructive surgery? Plastic surgery encompasses both cosmetic surgery and reconstructive surgery. Here’s how the Australian Society of Plastic Surgeons defines cosmetic surgery and reconstructive surgery:2As above
- Cosmetic surgery is designed to improve a person’s aesthetic appearance by altering or reshaping a bodily feature.
- Reconstructive surgery is concerned with improving bodily function and performed on abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumours, or disease.
Cosmetic surgery is not medically necessary (i.e. the treatment is elective), whereas non-cosmetic plastic surgery involves treatments that are considered to be medically necessary.
Can I get Private Health Insurance that covers cosmetic surgery?
Generally speaking, no. Not if it’s for purely cosmetic surgery.
Health funds aren’t required to cover treatments for which Medicare doesn’t pay a benefit. This means that health insurers won’t pay benefits for purely cosmetic procedures, or the hospital costs associated with them.3As above.
However, if the surgery is deemed medically necessary, then the treatment could be covered by your policy — so long as your policy covers plastic and reconstructive surgery.4As above.
For instance, even if a treatment alters your appearance, it might be covered by your policy if there’s a medically necessary reason to have it performed (such as breast reconstruction surgery following breast cancer).5Breast Cancer Network Australia – Breast reconstruction However, when it comes to plastic surgery that isn’t medically necessary, you’ll have to foot the bill yourself.
Keep in mind that some surgical procedures might include MBS item numbers from both the medically necessary plastic and reconstructive surgery category, and the category the body part comes under (such as podiatric surgery). Complicated stuff!
What types of plastic surgery might be covered by my Health Insurance policy?
Do I need plastic and reconstructive surgery as part of my Health Insurance policy?
We can never tell what might happen to us in the future and if you find yourself in a situation where you need plastic surgery, such as after an accident, knowing it’s covered by your Health Insurance can give you much-needed peace of mind.
Over 1,600 surgical procedures are listed under the plastic and reconstructive surgery category in the Medicare Benefits Schedule,7As above. so if your policy doesn’t cover you for these treatments—or if there are exclusions or restrictions—it could pose a problem if plastic surgery becomes medically necessary for you.
Which policies actually cover plastic and reconstructive surgery?
Hospital Cover in both the Silver and Gold product tiers is required to pay benefits for medically necessary plastic and reconstructive surgery.8PrivateHealth.gov.au – Product Tiers
Lower levels of hospital cover, such as Basic and Bronze policies, don’t cover plastic or reconstructive surgery.
What else should I look for in a Health Insurance policy?
Can I change my health insurance cover to include plastic surgery?
Yes, you can either upgrade your Private Health Insurance policy with your existing provider to cover the services you need or switch to a different provider who covers plastic and reconstructive surgery procedures.12As above. However, it’s important to be aware that a 12-month waiting period still applies if the treatment is for a pre-existing condition.13As above.
How can I find a health insurance policy that covers plastic surgery?
The iSelect team is here to help! We’ll help you compare* health insurance from a range of providers and policies to try help find the right level of cover for your needs. Call us now on 1800 784 772 to find out more about Health Insurance with plastic surgery.
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