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What you need to know
Weight loss surgery is covered by all gold-tier hospital policies.
The average cost of weight loss surgery is anywhere between $12,500 and $20,000.
Factors including anaesthetist fees, assistant fees and booking fees can impact the cost of weight loss surgery. Remember, the recovery period, and associated costs, will vary from person to person.
What is weight loss surgery?
Weight loss surgery is a medical procedure that helps you lose weight and lowers the risk of medical problems associated with obesity. It's available with all gold tier health insurance policies which cost around $150 to $200 a month. In some cases, you may be able to find it included in silver plus policies for a little less.
A hospital insurance policy can cover several types of weight loss surgery including gastric sleeve, gastric bypass and sleeve gastrectomy. In most cases, you'll need to serve a 12-month waiting period before you can claim. Read our guide to getting weight loss surgery to learn more about the process.
Average costs of weight loss surgery
The cost of weight loss surgery can run into thousands of dollars depending on the clinic you use and the type of surgery you opt for. Here's a breakdown of costs if you didn't have private health insurance:
Weight loss surgery cost. Without insurance, you can expect most weight loss surgery to cost between $15,000 and $20,000. This can differ depending on factors such as the doctor's fee, the anaesthetist fee, pathologist fees, the equipment used and paying for a hospital bed.
Gastric bypass cost. This is likely to cost you around $12,500 and $20,000, depending on who you go with.
Gastric sleeve cost. Gastric sleeve surgery costs are usually similar in price to other types of bariatric surgery and are likely to be around or above $20,000.
How much does lap band surgery cost? This usually costs between $14,000 and $18,000.
Making sure you have the best health insurance that suits your needs is the best way to minimise the cost of any weight loss surgery that you may need.
Factors that impact the cost of weight loss surgery
There are a few factors that impact the cost of weight loss surgery. You need to take them all into account when working out how much it will cost you and what your out of pocket expenses might be.
Principal surgeon's fees
Anaesthetist fees
Assistant fees
Theatre costs
Excess fee
The type of surgery you have
Diagnostics fees such as lab tests and medical imaging
Booking fees
Psychologist fees
The length of your hospital stay
Dietician fees associated with post-surgery exercise and diet counselling
Additional surgeries to remove excess skin and improve loose muscles
Does insurance cover the costs of weight loss surgery?
Yes, you can get health insurance for weight loss surgery. Gold tier private health insurance covers weight loss surgery which includes gastric bypass, gastric sleeve and lap band surgery. You'll need to serve a 12-month waiting period before you're covered.
Health insurance won't eliminate out of pocket expenses, but in most cases, you're likely to pay closer to around $2,000 to $6,000. Health insurance can cover the costs of:
The device (band)
Surgeon, hospital and anaesthetist fees, including a private room in a private hospital
Any face-to-face consultations with your bariatric surgeon
With private health insurance, your main out of pocket expenses will most likely be a portion of the surgeon and assistant's fee as well as the anaesthetist's fee. Speak directly with your surgeon to find out about exact costs. You can then relay that to your health insurer and they'll let you know how much they will cover. It's a good idea to compare health insurance from multiple providers to make sure you get the best deal.
If your surgery is deemed medically necessary, then Medicare may contribute a small amount towards your medical costs as well, usually around $1,200 to $1,500 depending on the Medicare Benefit Schedule (MBS) codes that apply to your surgery.
The main codes for weight loss surgery are: 30166, 30169, 30177, 30179, 31569, 31572, 31575, 31578, 31581, 31584, 31585, 31587, 31590.
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Frequently asked questions
Yes, Medicare can cover weight loss surgery, but only if it's deemed medically necessary and you meet specific requirements (for example, you have a BMI of at least 35). You also won't be approved until you meet with a physician for an in-depth, face-to-face consultation.
Gastric sleeve surgery costs are usually similar in price to other types of bariatric surgery and are likely to be around or above $20,000 in Australia.
Yes. You will have to hold health insurance that covers weight loss surgery for 12 months before you are covered. It's included with all gold-level hospital policies.
To qualify for lap band surgery, patients must have a BMI of at least 40 or a body max index (BMI) of at least 30 whilst suffering at least one serious obesity-related, comorbid health concern and be at least 13.6 kilograms overweight. Furthermore, to qualify for bariatric surgery, patients must have a BMI of over 40 or a BMI of over 35 and have other serious health concerns such as heart disease and diabetes. If you want to find out if you qualify for weight loss surgery, we recommend you contact your gp or online doctor and have a consultation to explain your situation.
Yes, the MLHD Metabolic Obesity Service (MOS) is a pathway program to weight loss surgery through education, focussing on lasting behavioural changes. This program is available for residents in rural or remote NSW and includes 4 appointment phases. However, there is a 10-12 month wait to be invited to an initial invitation session.
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, news.com.au, The Telegraph, Explore Travel and Escape. Gary holds a Kaplan Tier 1 General Insurance (General Advice) certification and a Kaplan Tier 1 Generic Knowledge certification which meets the requirements of ASIC Regulatory Guide 146 (RG146).
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