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.
Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
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Comparing quotes from 30+ funds...
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
You pay nothing. Finder is free to use. And you pay the same as going direct. No markups, no hidden fees.
You save time. We spend 100s of hours researching health insurance so you can sort the gold from the junk faster.
You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
Gary Ross Hunter was 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). See full bio
Gary Ross's expertise
Gary Ross has written 725 Finder guides across topics including:
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You pay nothing. Finder is free to use. And you pay the same as going direct. No markups, no hidden fees.
You save time. We spend 100s of hours researching health insurance so you can sort the gold from the junk faster.
You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
