What You Need to Know About Health Insurance and Cosmetic Surgery

Cosmetic surgery is often associated with facial alterations, boob jobs and other elective and appearance-based procedures.

But what most people don’t know is that there is a huge range of cosmetic treatments and operations that can be considered completely medically necessary.

Medically necessary procedures can be covered by your private health insurance, so when the time comes to fund your cosmetic surgery, it’s really important to understand the distinction between necessary and elective procedures. Here’s how:

Figure out which one’s which

Much of the distinction between whether something is necessary or elective comes down to whether it’s deemed to be medically necessary by a professional.

Reconstructive plastic surgery is typically used to correct a range of abnormalities, whether they’re congenital or acquired, or to repair trauma damage that has occurred as the result of an accident.

At the end of the day, if a doctor or specialist formally recommends surgery, there is a high chance that it will be recognised by your health insurance provider – or at the least, Medicare – as something that warrants a rebate.



Know what you can claim back

There are a few kinds of procedures that a comprehensive private health insurance policy should typically provide cover for (depending on the level of cover you opt for):

  • Surgeries for congenital abnormalities (conditions that exist at or before birth).
  • Reconstructive surgery following an extreme burn.
  • Surgeries for traumatic injuries.
  • The removal of cancers or tumours (or surgeries that follow the removal of cancers or tumours, such as a post-mastectomy reconstruction).
  • Procedures that repair scars or skin lacerations.

Get the best value from your health insurance

Don’t be so quick to exclude or restrict plastic surgery from your policy. While in the short term it may help you to save money on your premiums, you can never predict whether you might need surgery in the future.

It’s also a good idea to remember the distinction between reconstructive plastic surgery and elective cosmetic surgery when reviewing your policy. Some people find it easy to get confused and will accidentally remove reconstructive procedures from their cover.

If you’re looking into taking out a higher level of cover, compare health insurance policies for cosmetic surgery online to make sure you’re getting the best value for your money.

Know your options

There are three main private health insurance options for plastic and reconstructive surgery. You can:

  • Take out a comprehensive policy that covers reconstructive plastic surgery.
  • Choose a policy that offers restrictive cover for reconstructive plastic surgery in order to lower your premiums.
  • Choose a policy that excludes cover for reconstructive plastic surgery altogether.

What you choose is completely up to you. If you’re unsure of where to seek advice, have a look at the Ombudsman’s website.


Written by Bessie Hassan

Bessie Hassan is finder.com.au’s resident Insurance Expert.







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