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Health insurance for excess skin removal

Health insurance can cover excess skin removal, such as a tummy tuck, if it's considered medically necessary by your doctor.

What you need to know

  • Excess skin removal can be covered by all Silver and Gold policies.
  • The table below lists some policies from Finder partners that can cover excess skin removal.
  • Policies start from around $169.48 per month.

Private health insurance that covers excess skin removal

Excess skin removal is covered in some Silver Plus and Gold policies. The table below lists some policies from Finder partners that cover excess skin removal, typically with a 12-month waiting period because it will be considered a pre-existing condition.

1 - 4 of 4
Name Product Treatments Price Apply
Frank Gold Hospital
Gold$750 excess
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$226.63
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$228.93
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$237.33
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$253.17
per month
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All prices are based on a single individual with less than $90,000 income and living in Sydney.

Can health insurance cover excess skin removal?

Yes but only if it is considered medically necessary. It is typically covered under "Plastic and reconstructive surgery (medically necessary)" which is included in all Silver policies and above.

To get approved, you typically need to meet all of the following conditions:

  • Your BMI has dropped at least 5 points.
  • Your weight has been stable for 6 months prior to the surgery.
  • You've developed a secondary skin condition that threatens the health of your skin and has failed other forms of treatment.
  • The excess skin interferes with daily living.
Clock
Waiting periods
If you buy a new policy, you'll have to serve a 12-month waiting period for excess skin removal in most cases because it will usually be considered a pre-existing condition.

How does health insurance cover excess skin removal?

Public system icon

Medicare

Medicare will pay for 75% of the MBS costs if you receive treatment as a private patient in a private hospital. There are a few different Medicare item numbers associated with excess skin removal – all depend on the type of procedure you will receive. For example, 30177 is for a lipectomy.

Private contract icon

Private health

Private health insurance will pay for the remaining 25% of the MBS fee. If your surgeon charges more than the MBS fee (they're legally allowed to do this), you might still have out of pocket expenses, unless your insurer has a no gap fee agreement with your hospital.

Pros and cons of going private

Pros

  • You won't have to wait as long for treatment. Wait times in the public system will probably be quite long since excess skin removal isn't a life-threatening emergency.
  • You can choose your surgeon. In the public system, you have to go with whoever they give you.
  • You get your own room. Many public hospitals use shared rooms. You can avoid this and enjoy the privacy of your own room by using private health cover.

Cons

  • You might have out of pocket expenses. Surgeons operating in private hospitals do not need to adhere to the recommended MBS fees.

What excess skin removal procedures can health insurance cover?

  • Tummy tuck. Removes excess skin around your abdomen and tightens the abdominal muscles. Technically called an abdominoplasty.
  • Lower body lift. Removes excess fat and loose skin around the stomach, thighs, back and buttocks.
  • Upper body lift. Removes the excess fat and loose skin around the chest, breasts and mid-back.
  • Arm reduction. Removes excess skin and tissue around the arm, armpit and side chest.
  • Thigh reduction. Removes excess skin and fat around the thighs.
  • Liposuction. Removes stubborn areas of fat. Can be used together with skin reduction to help create nicer body contours.

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