Finder makes money from featured partners, but editorial opinions are our own.

Health insurance for appendicitis

Emergency appendix removal is partially covered by Medicare, while some private health insurance policies can cover the rest.

Medicare can fully cover appendix surgery as long as you receive treatment in a hospital. If you want to choose your own doctor, hospital and potentially get treated quicker, you might be better with health insurance. Appendix treatment is available with most policies for as little as $72 per month.

Appendicitis surgery cost in Australia

If you're treated as a public patient in a public hospital, appendicitis surgery is generally free in Australia.

However, you'll have some out of pocket expenses if you get treated in a private hospital and don't have health insurance. For example, the fee listed on the Medicare Benefits Schedule for an appendicectomy is $463.50. As Medicare covers 75% or $347.65 of the scheduled fee, you'll need to pay the remaining 25% of the fee yourself — that's $115.85.

It's extremely unlikely to be that cheap though as doctors often charge much more than the MBS fee. You will also need to consider anaesthetist, assistant and diagnostic fees.

Compare health insurance for appendix removal

You'll find health insurance for appendix removal in all bronze level health insurance policies, but a handful of basic policies can cover you as well. We've listed them below alongside costs. Keep in mind that you'll have a 2 month waiting period for new conditions or 12 months for pre-existing ailments. All prices are based on a single individual with less than $93,000 income and living in Sydney.

1 - 10 of 16
Name Product Treatments Price Apply
Basic Plus Hospital $750
Basic Plus$750 excess
  • Rehabilitation
  • Joint reconstructions
  • Dental surgery
  • Hernia and appendix
  • Eye excluding cataracts
  • Pain management
  • Gynaecology
  • Lung and chest
  • +6 other treatments covered
$82.21
per month
Frank Entry Hospital (Basic+)
Basic Plus$750 excess
  • Rehabilitation
  • Joint reconstructions
  • Dental surgery
  • Hernia and appendix
  • Eye excluding cataracts
  • Pain management
  • Gynaecology
  • Lung and chest
  • +5 other treatments covered
$82.48
per month
  • Rehabilitation
  • Joint reconstructions
  • Dental surgery
  • Hernia and appendix
  • Eye excluding cataracts
  • Pain management
  • Gynaecology
  • Lung and chest
  • +8 other treatments covered
$84.51
per month
  • Rehabilitation
  • Joint reconstructions
  • Dental surgery
  • Hernia and appendix
  • Eye excluding cataracts
  • Pain management
  • Gynaecology
  • Lung and chest
  • +5 other treatments covered
$85.23
per month
Basic Plus Hospital $500
Basic Plus$500 excess
  • Rehabilitation
  • Joint reconstructions
  • Dental surgery
  • Hernia and appendix
  • Eye excluding cataracts
  • Pain management
  • Gynaecology
  • Lung and chest
  • +6 other treatments covered
$85.92
per month
essentials basic plus
Basic Plus$750 excess
  • Rehabilitation
  • Joint reconstructions
  • Dental surgery
  • Hernia and appendix
  • Eye excluding cataracts
  • Pain management
  • Gynaecology
  • Lung and chest
  • +5 other treatments covered
$87.04
per month
Basic Plus Hospital 750
Basic Plus$750 excess
  • Rehabilitation
  • Joint reconstructions
  • Dental surgery
  • Hernia and appendix
  • Eye excluding cataracts
  • Pain management
  • Gynaecology
  • Lung and chest
  • +6 other treatments covered
$87.72
per month
  • Rehabilitation
  • Joint reconstructions
  • Dental surgery
  • Hernia and appendix
  • Eye excluding cataracts
  • Pain management
  • Gynaecology
  • Lung and chest
  • +7 other treatments covered
$88.30
per month
Basic Plus Hospital $750/$1500
Basic Plus$750 excess
  • Rehabilitation
  • Joint reconstructions
  • Dental surgery
  • Hernia and appendix
  • Eye excluding cataracts
  • Pain management
  • Gynaecology
  • Lung and chest
  • +3 other treatments covered
$89.19
per month
  • Rehabilitation
  • Joint reconstructions
  • Dental surgery
  • Hernia and appendix
  • Eye excluding cataracts
  • Pain management
  • Gynaecology
  • Lung and chest
  • +7 other treatments covered
$89.42
per month
loading

Finder survey: How many Australians of different ages made a hospital claim for any of these conditions?

Response75+ yrs65-74 yrs55-64 yrs45-54 yrs35-44 yrs25-34 yrs18-24 yrs
Cataracts27.27%8.72%3.11%0.59%0.54%2.35%
Joint replacements18.18%3.49%1.86%1.18%0.54%1.05%1.18%
Dental surgery11.36%4.07%4.97%3.55%3.78%3.16%7.06%
Gastrointestinal endoscopy11.36%9.3%7.45%2.96%5.41%2.63%
Heart and vascular system11.36%7.56%5.59%0.59%2.7%1.05%
Hernia and appendix11.36%2.91%4.35%2.96%2.16%1.58%
Eye surgery (not cataracts)9.09%4.65%2.48%1.08%1.58%3.53%
Pregnancy and birth9.09%2.91%3.73%6.51%5.41%3.68%
Bone joint and muscle6.82%5.23%4.97%2.37%2.7%2.11%1.18%
Cancer treatment6.82%7.56%1.86%0.59%1.62%1.58%
Gynaecology6.82%4.65%5.59%7.1%4.86%3.16%
I've never made a hospital claim6.82%8.14%14.91%19.53%24.32%28.42%27.06%
Joint reconstructions6.82%2.91%2.48%0.54%1.05%
Rehabilitation6.82%1.74%1.86%3.78%3.16%1.18%
Brain and nervous system4.55%0.58%0.62%0.59%1.08%0.53%1.18%
Breast surgery4.55%1.74%0.54%1.58%
Lung and chest4.55%0.58%1.24%2.37%0.54%0.53%
Skin4.55%2.33%1.86%1.78%1.62%2.11%1.18%
Sleep studies4.55%4.65%1.24%0.59%1.08%
Back neck and spine2.27%1.74%3.11%1.18%2.16%
Blood2.27%1.86%1.18%1.08%1.18%
Ear nose and throat2.27%4.65%6.21%1.78%3.78%3.68%3.53%
Other2.27%2.91%4.97%5.92%5.41%5.79%3.53%
Pain management2.27%1.16%2.48%2.37%2.7%1.05%1.18%
Tonsils, adenoids and grommets2.27%1.16%0.62%1.18%3.78%3.16%1.18%
Weight loss surgery2.27%1.24%1.78%1.08%1.18%
Digestive system2.91%3.11%1.78%1.08%2.11%1.18%
Male reproductive system2.33%1.24%1.18%0.54%1.58%
Diabetes management1.16%0.54%0.53%
Kidney and bladder1.16%1.24%1.18%1.62%0.53%
Podiatric surgery1.16%1.24%0.59%0.53%
Plastic or reconstructive surgery0.58%1.86%1.05%
Hospital psychiatric services1.86%0.59%4.32%0.53%1.18%
Miscarriage1.24%1.78%1.62%
Dialysis for chronic kidney failure0.62%0.53%
Assisted reproductive services1.78%1.62%1.05%
Pain management with device0.59%2.16%1.58%
Palliative care0.59%1.62%1.18%
Source: Finder survey by Pure Profile of 1006 Australians, December 2023

Does Medicare cover appendix surgery?

Yes. If you're treated as a public patient in a public hospital, Medicare can cover 100% of appendix surgery expenses. Remember though, as a public patient, you generally won't be able to choose your own doctor or the day that you're admitted to hospital and receive surgery.

If you receive treatment as a public in a private hospital, the Medicare Benefits Schedule Fee (30720) for an appendicectomy is $463.50, of which Medicare covers 75%. However, doctors aren't obligated to stick to the MBS fee, so you might have to pay considerably more than the 25% if they do charge more.

How does health insurance cover appendix surgery?

You'll find appendix removal covered with all bronze tier health insurance policies under hernia and appendix. With private health insurance, you can choose your own doctor, hospital and in many cases, you'll get treated much quicker.
If you already have health insurance, chances are you've already served the waiting period as it's included in most policies.

The majority of insurers cover the cost of surgical and theatre fees, as well as for any medicine you receive whilst in hospital. It will also generally cover the cost of accommodation in a private hospital or bed.

There may be some out of pocket expenses if you don't have some form of gap cover. To have a good indication of any out of pocket expenses, you should find out the price of the following:

  • Principal surgeon
  • Anaesthetist
  • Assistants
  • Diagnostics for example x-rays, lab tests and medical imaging

How finder partners cover appendix in detail

Health fundWhat services are covered?Apply
ahm-fund-page-logoAHMAHM hospital cover policies cover the surgical removal of your appendix if you have appendicitis and need hospital treatment except for Starter Basic Hospital cover. This includes all agreed hospital charges in a partner private hospital in a shared or private room. In a public hospital, AHM will cover accommodation charges for a shared room and pay benefits towards the cost of a private room. A 12-month waiting period applies for pre-existing conditions, but this is shortened to two months in all other cases.More info
Australian Unity logoAustralian UnityIf you require appendix removal, hospital cover from Australian Unity covers hospital accommodation costs, theatre fees, in-hospital pharmaceuticals and more . A two-month waiting period applies.More info
GMHBA-logo GMHBAGMHBA Hospital Cover includes cover for theatre fees, doctor's fees and accommodation in a public or private hospital when you need to have your appendix removed except for Basic Plus (Restricted). Pharmaceuticals you receive as an inpatient are also covered. A two-month waiting period applies.More info
HCF-Logo HCFHCF Hospital Cover provides cover for the cost of an appendectomy, including hospital accommodation, theatre fees, surgical fees and pharmaceuticals. Whether or not you receive treatment in a private or public hospital varies depending on the level of cover you select. A two-month waiting period applies.More info
 hif logoHIFIf you need to have your appendix surgically removed, cover is provided by HIF's suite of health insurance policies. This includes accommodation in a private hospital or as a private patient in a public hospital, plus theatre care, surgical fees and pharmaceuticals you receive in hospital. A two-month waiting period applies.More info
transport healthTransport HealthAll of Transport Health's hospital cover policies include cover for appendix removal. This includes hospital accommodation, emergency ambulance transport, theatre fees and pharmaceuticals. A two-month waiting period applies.More info

What will happen if appendicitis is left untreated?

If left untreated, appendicitis is a potentially life-threatening condition. With this in mind, doctors will always take a cautious approach and operate on a patient, even if a confirmed diagnosis of appendicitis has not been reached.

Why you can trust Finder's health insurance experts

free

We're free

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.
expert advice

We're experts

We've researched and rated hundreds of policies as part of our Finder Awards. We've published 250+ guides and our in-house experts regularly appear on Sunrise, 7News and SBS News.
independent

We're independent

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).
help

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.

More guides on Finder

Go to site