Is Breast Reduction Surgery Covered by Medicare?
- At this point in time, the answer is still “Yes” and there is no fine print attached.
- Every breast reduction performed has a Medicare eligible item number.
- This does not mean that all of your fees are covered.
- It means you will get a set rebate on your surgeon’s fees and anaesthetic fees.
- Hospital fees are never covered by Medicare.
What does this mean in financial terms?
- All breast reduction surgery is paid for before your surgery.
- After the date of surgery, you can claim the schedule fee rebate of $1029.25 on a bilateral breast reduction
- The cost of breast reduction will vary from one surgeon to the next.
Will my Private Health Fund cover the costs of breast reduction surgery?
- If you have private health insurance, including hospital cover with no exclusions, your health fund should cover all hospital fees (with the exception of any co-payment arrangement you may have)
- You may still have out-of-pocket costs for your anaesthetist and your surgeon.
- Your surgeon’s theatre booking staff will be able to give you exact information on what you will and won’t be covered for with your level of cover.
Can I have a breast reduction in a public hospital?
- Technically yes. You will be placed on a waiting list as a Category 3
- All Category 1 and Category 2 clients must be operated on in a timely fashion, or the hospital is penalised financially.
- Once this has occurred, Category 3 clients are called forward in order of how long they have been on the waitlist.
- This process often takes many years.
How do I choose a surgeon for my breast reduction surgery?
- When it comes to surgery on your body, cost should be your last consideration.
- We would recommend choosing a surgeon according to his/ her level of skill and the results posted on their website, as opposed to cost.
- When looking at results, you want a surgeon that has many examples of the breast reductions they have performed. Everyone will have a few good results. Choose someone with loads of before and afters, with consistently good results.