How does health insurance cover brain surgery?
Treatments for the brain and nervous system - including brain surgery - is covered by Medicare in a public hospital, or by bronze tier private hospital policies.
Key takeaways
- Brain surgery is a medical specialty that involves the surgical treatment of conditions and disorders of the brain and nervous system.
- Brain surgery can be used to treat a variety of conditions and perform procedures to manage symptoms and improve function.
- A bronze tier private health insurance policy can help cover the cost of private surgery.
What counts as brain surgery
Put simply, brain surgery is anything where you need medical surgery inside the chrome dome (aka your skull). This can include everything from biopsies or keyhole surgery, all the way up to major surgery. If you're looking for brain surgery on your health insurance, the official treatment category is 'brain and nervous system' treatments.
How can I pay for brain surgery?
Both Medicare and private health insurance can contribute towards the cost of brain surgery. The biggest difference is based on whether you are treated in a public or private hospital.
Medicare
If you're treated as a public patient in a public hospital, Medicare can cover 100% of your brain and nervous system treatment. Public hospitals will only charge the MBS fee, and that will all be covered if you have Medicare. If you have any care outside of hospital, for example a specialist or follow up rehabilitation, Medicare may not cover the whole cost, leaving you with an out of pocket cost.
Private health insurance
You can get private health insurance for brain and nervous treatment with all bronze tier hospital policies. This can cover you for care in a private hospital and can include investigation and treatment of the brain, chemotherapy, immunotherapy for cancer and more. The cheapest bronze policies start from around $91 a month. Keep in mind that for private hospital treatments, you will often have out of pocket payments to pay, even after your insurance has contributed.
How does medicare cover brain surgery and treatment?
Medicare will usually cover the cost of staying and being treated as a public patient in a public hospital. You generally won't be able to choose your own doctor or choose when you want to undergo brain treatment or surgery. This is largely because public waiting times are normally longer as they're busier, so you don't have the same flexibility as you would with private health care.
Medicare will also pay a benefit towards seeing a specialist, such as a neurosurgeon. The neurosurgical consultation structure consists of an initial consultation (Medicare Benefits Schedule no. 6007) and four categories of subsequent consultations. These categories relate to both the length of consultation time and the complexity of what is being discussed. Here's a break down of some of the prices (correct as of 1 July 2026):
- Level 1. 6009 - Fee: $52.25 Benefit: 75% = $39.20, 85% = $44.45
- Level 2. 6011 - Fee: $103.95 Benefit: 75% = $78.00, 85% = $88.40
- Level 3. 6013 - Fee: $144.00 Benefit: 75% = $108.00, 85% = $122.40
- Level 4. 6015 - Fee: $183.35 Benefit: 75% = $137.55, 85% = $155.85
Medicare also provides cover for deep brain stimulation, which is sometimes required for Parkinson's disease or for treating tremors or dystonia. Because there are so many different types of brain treatment, you should contact Services Australia or check your Medicare online account through myGov to find out exactly what you're covered for.
How does private health insurance cover treatment?
You can get private health insurance for brain and nervous treatment with all bronze tier hospital policies. The cheapest bronze policies start from around $91 a month, and they can help cover the cost of:
- Investigation and treatment of the brain
- Brain-related conditions
- Spinal cord and peripheral nervous system
- Chemotherapy, radiotherapy and immunotherapy for cancer (these come under a separate service but are also included in all bronze policies)
Waiting periods: You'll have to serve a waiting period of 2 months before you can make a claim
How much does health insurance cost?
We ask hundreds of Australians what they're paying for health insurance every month. Here's what their bill looked like in March 2026.
- Extras only: $53
- Basic: $90
- Bronze: $144
- Silver: $184
- Gold: $285
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