What Are the Costs Associated with Breast Reduction Surgery?

You will have 3 main fees:

  1. Surgeons Fee – for the actual surgery performed by Dr McGovern
  2. Anaesthetists Fee – for the General Anaesthetic administered and your care whilst under anaesthetic for the duration of the surgery, which is between 3-4 hours and the recovery period which can be 1 – 2 hours.
  3. Hospital Fee – covers the cost of staff in the operating theatre and the ward (approximately 5 staff members), and the disposables required for surgery, your anaesthetic and your day bed.

Additionally, you will have a pathologist’s fee if you are not privately insured. See below for details.

Are the Costs of Breast Reduction Surgery Covered by Medicare?

Breast reduction surgery is classified as a Medicare-eligible procedure.

There is no fine print about how much breast tissue must be removed to be Medicare-eligible.

There is no fine print to say that you have to have back pain or other problems to receive Medicare eligibility for your breast reduction.

This does not mean that Medicare pays for your breast reduction surgery entirely.

What Does Medicare Cover in Relation to the Cost of Breast Reduction Surgery?

Medicare eligibility for breast reduction means that Medicare will rebate a portion of your surgeons’ and anaesthetic fees.
You will still have an out-of-pocket component to your surgery.

Our cosmetic consultant can help you with this information.  Please call 040972922.

Medicare eligibility means that there is no GST payable on breast reduction surgery fees.

Medicare does not cover any of your hospital fees.

Does My Private Health Insurance Cover the Costs of Breast Reduction Surgery?

If you have private hospital health insurance, your insurer should cover the cost of your hospital fees for breast reduction, less any excess that you have agreed upon.

Any excess will be paid to the hospital on the day of your surgery.

There are no rebates on excess payments. 

If you have chosen to reduce your annual health insurance fees by choosing to exclude plastic surgical item numbers from your policy, you will not have any private health fund contributions toward breast reduction surgery.

Breast reduction surgery is a plastic surgical item.

To check your eligibility, call your health fund and quote item number 45523.

If your private health insurance covers breast reduction surgery, they will rebate a portion of your surgeons and anaesthetic fees, over the Medicare rebate.

When Do I Receive the Medicare Rebate on Breast Reduction?

Medicare rebates can be claimed on or after the date of your breast reduction surgery.

When Do I Receive Private Health Fund Rebates on Breast Reduction?

If you are covered for hospital costs for breast reduction, the hospital will bill your health fund directly on the day of your surgery.

You simply pay the hospital any excess you have agreed upon as part of your health insurance policy, at the time of admission.

Private health fund rebates on your breast reduction surgeons’ fees and anaesthetic fees can be claimed on or after the date of your surgery.

If you submit the claim directly to your health insurer, they will claim the Medicare portion for you as well and pay both into your bank account.

*Pathologists Fees

All breast tissue removed is sent to pathology to be examined to ensure there are no breast cancer cells in the breast tissue.

The pathologist will issue an invoice for this service after your breast reduction surgery.

Medicare will cover some of this fee.

Private health funds may cover the remaining costs.