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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.
We update our data regularly, but information can change between updates. Confirm details with the provider you're interested in before making a decision.
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.
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?
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 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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Frequently asked questions
Yes, it can be. However, it needs to be medically necessary and not for cosmetic reasons. For example, you typically need to have lost a substantial amount of weight (at least 5 BMI points), have developed skin conditions and are unable to do everyday activities such as exercise.
Health insurance companies in Australia must cover weight loss surgery as part of their Gold level policies which can include excess skin removal. However, it needs to be medically necessary. You won't be covered for cosmetic surgery.
Abdominoplasty – also known as a tummy tuck – is not covered by private health insurance. This is because it's generally done for cosmetic purposes. Private health insurance will only cover you for medically necessary treatment.
To remove excess skin, your surgeon will make incisions into the area where the excess skin is located, lift the skin from the underlying tissue, trim it off, reposition the navel if necessary and stitch up the wound.
If liposuction is required, the process is the same except they'll remove the excess fat before trimming away the skin. They do this by hollowing out little spaces within the fatty tissue. After they trim the skin and stitch the wound, they'll give you a compression garment that will collapse these hollowed-out spaces to create a contoured body shape.
In the case of a tummy tuck, the process is again the same, but your surgeon will stitch together any loose or separated abdominal muscles prior to removing the fat.
Gary Ross Hunter is an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, news.com.au, The Telegraph, Explore Travel and Escape. Gary holds a Kaplan Tier 1 General Insurance (General Advice) certification and a Kaplan Tier 1 Generic Knowledge certification which meets the requirements of ASIC Regulatory Guide 146 (RG146).
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