Will Medicare cover my Cosmetic Surgery in Australia?
When it comes to surgery in Australia, one of the most frequently asked questions to our Plastic surgeon is “can my surgery be covered by Medicare?”
Medicare currently only covers medical and surgical procedures that are clinically necessary for your health. They won’t cover elective cosmetic surgery procedures that you choose to pursue for purely cosmetic reasons, such as Liposuction on your thighs.
While most procedures are just for cosmetic benefits, there are cases where they are also done for functional and health benefits, such as a Breast reduction if a patient has recurring back pain or skin infections.
It’s not possible to give a defined yes or no answer as it varies from patient to patient and you have to fit a certain criteria to be qualify for coverage, but there are circumstances where you could get a small Medicare rebate.
So what are some medical reasons for Plastic surgery that Medicare MAY cover?
- Plastic surgery following skin cancer removal
- Facial reconstructive surgery after an accident
- Rhinoplasty (corrective nose surgery/nasal area reshaping) to rectify an obstructed nasal passage where breathing is impaired by a nose injury or other nasal structural abnormality
- Damaged abdominal areas after pregnancy or C-Section delivery (specific criteria apply which your GP may be able to advise you about).
- Breast reconstruction following a mastectomy or other breast cancer treatments
- Surgery following rapid weight loss (surgical excision and reduction of excess, loose skin or redundant tissue folds including through abdominoplasty, belt lipectomy or similar procedures
- Eyelid Lift Surgery where sagging upper eyelid skin impedes vision
- Breast lift or Breast Reduction Surgery may occasionally be eligible for MINOR Medicare Rebates for some patients that meet very specific criteria; such as if you have severe breast ptosis or other recurring health problems related to the size, position or skin condition of your breast area. Only Medicare makes the final determination of what’s covered or not, usually on a case by case basis
Who do I speak to about Medicare Rebates?
If you are contemplating having a cosmetic procedures for medical purpose, it’s best to discuss it with your GP. If they think you might be eligible they can then refer you to a Plastic surgeon for a consultation. You can of course just go straight to your Plastic surgeon for a consultation, but for any potential rebates, a referral is necessary.