Medicare and health insurance won't pay for cosmetic surgery because it's not medically necessary — for example, surgery intended to improve a person's aesthetic appearance. However, you can get insured for reconstructive surgery that corrects abnormalities and repairs bodily function. You'll find it included in a bronze-level health insurance policy or above.
Which health funds cover medically necessary plastic surgery?
Here's a sample of policies from Finder partners that include private cover for plastic surgery. All prices are based on a single individual with less than $93,000 income and living in Sydney.
We update our data regularly, but information can change between updates. Confirm details with the provider you're interested in before making a decision.
Compare prices from 30+ Aussie funds in under 30 seconds.
How does health insurance cover reconstructive and cosmetic surgery?
Plastic surgery can be split into two categories:
Reconstructive surgery is performed to correct abnormalities, whether they're congenital or acquired, and repair damage as a result of trauma.
It's covered by Medicare and health insurance because it's considered medically necessary.
Cosmetic surgery is typically carried out to improve appearance rather than health. For example, facelifts, implants, eyelid surgery and liposuction.
It's not covered by Medicare or health insurance because it's not considered medically necessary.
Finder survey: How many people made a hospital claim for any of these conditions?
Response
Female
Male
Plastic or reconstructive surgery
0.96%
0.21%
Source: Finder survey by Pure Profile of 1006 Australians, December 2023
What plastic surgery procedures does private health insurance cover?
If you need to undergo reconstructive plastic surgery, you can get cover for the following types of procedures:
Surgeries on congenital abnormalities. A condition that exists at or before birth, such as a cleft palate or a nasal deformity that results in breathing difficulties.
Surgeries following burns. Skin grafts, reduction of skin tightening and treatment of scarring.
Surgeries following traumatic injuries. Facial bone fractures and breaks that need to be repaired or reset.
Surgeries following the removal of cancers or tumours. Breast reconstruction following a mastectomy and skin grafts following the removal of a tumour.
Surgeries to repair scars. Lacerations or scarring.
Do I need health insurance for plastic surgery?
It's impossible to predict what the future holds and what sort of medical treatment you may require. If reconstructive plastic surgery is excluded from your cover, you could be hit with significant out-of-pocket costs should you ever need treatment.
You can also get health insurance for plastic surgery with some bronze plus policies. These only cost around $95 a month. If you want peace of mind, it may be worth switching to a policy that covers you.
Why you can trust Finder's health insurance experts
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Our health insurance engine is completely free to use. You pay the same as buying directly from the health insurer. Better still, we regularly run exclusive deals that you won't find on any other site.
Unlike other comparison sites, we're not owned by an insurer. That means our opinions are our own and you can compare nearly every health fund in Australia on the site (and find a better deal).
We're here to help
Since 2014, we've helped 350,000+ people find health insurance by explaining your options simply. We'll never ask for your number or email to see prices. We're here to help you make a decision.
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, The Guardian and news.com.au. Gary holds a Kaplan Tier 2 General Advice General Insurance certification which meets the requirements of ASIC Regulatory Guide 146 (RG146).
Want to get health cover for grommets? Find out how private health insurance and Medicare costs compare and what you'll be covered for. Choose the option that suits you best.
Find the answers to the most common questions about health cover excesses in this helpful guide.
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