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.
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 $90,000 income and living in Sydney.
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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.
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.
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.
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