Cosmetic surgery isn't covered by health insurance, but medically necessary plastic surgery is.
Who is this cover for?
No contact details required
Compare 40+ funds
Same price as going direct
Back
Close
I'm Tim, your insurance expert.
Here to help you find the right cover for you!
Step 1/2 - About your cover
Which state do you live in?
QLD
NSW
ACT
VIC
TAS
SA
WA
NT
What's your age?
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 November 2024, in line with Finder's database of health insurance policies. Prices reflect the cheapest available for a single individual with less than $97,000 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
Create a Finder account to get an email copy of your results (optional)
Enter your email address
By entering your email address, you agree to create a Finder account subject to our Privacy & Cookies Policy and Terms of Service. We will send you an email to setup your password.
Why compare with us
You'll pay the same price as going direct - we don't
charge fees
We don't ask for your phone number to see prices
Hang tight - we're fetching policies just for you!
These products offer a balance between low pricing and more features.
7+
Great
Competitive products within their group.
5+
Standard
Usually these products would either have fewer treatments covered or higher pricing.
0+
Basic
Offering basic cover with limited features or higher pricing.
Key takeaways
Medicare or insurance will not pay for cosmetic surgery that is not medically neccessary.
However you can get cover for reconstructive surgery with a valid medical reason.
This is covered by the bronze tier of private hospital insurance.
How does Medicare or health insurance cover cosmetic surgery?
Plastic surgery can be split into two categories - reconstructuve and cosmetic surgery. Whether your treatment will be covered by Medicare or private hospital insurance depends on which category it falls into.
Reconstructive surgery
Reconstructive surgery is performed to correct abnormalities. These could be from birth or acquired through life, or be damage as a result of trauma or a bad accident.
Reconstructive surgery is generally considered medically neccessary and will covered by both Medicare and your private hospital insurance.
Cosmetic surgery
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 counts as medically neccessary for plastic surgery?
There are a lot of valid medical reasons for plastic surgery. A few examples include the following:
Reconstructive facial surgery after a bad car accident
Surgey to correct your nose if you're unable to breathe properly
A single breast reduction to even them out after removing a cancerous breast
Policies that cover medically neccessary 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 $97,000 income and living in Sydney.
Each month we analyse over 10,000 hospital insurance products and rate each one on price and features. What we end up with is a nice round number out of 10 that helps you compare hospital cover a bit faster.
Before we start scoring, we need to make sure we're comparing like-for-like. Just as it doesn't make sense to compare a bicycle with a Ferrari, it doesn't make sense to compare basic hospital policies to top-tier Gold policies. Each policy is given a price score and feature score. These are then combined to determine each policies's Finder Score.
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
Email me my results (optional)
To get a copy of your results for later, add your email below
You'll pay the same price as going direct - we don't
charge fees
We don't ask for your phone number to see prices
Hang tight - we're fetching policies just for you!
Comparing quotes from 40+ funds...
Medicare vs private for medically neccessary plastic surgery
There will be some differences to your experience in the public or private system. Assuming your hospital cover is enough to cover the procedure, the big differences will be around surgery wait times and out-of-pocket costs.
Surgery wait times
When you need surgery, you'll be put into a queue of people waiting for a spot with a surgeon. There are wait lists for both the private and public system, but the private lists are generally a lot shorter.
How long are the lists? It depends, unfortunately. Public waiting lists can often be in the months or years. It will also depend on how urgernt your condition is. If you need urgent work as the result of trauma, you'll probably get seen very quickly. On the other hand, surgery that's deemed less urgent might see you drop down the list a lot.
Private hospital insurance is generally the most reliable way to get quick treatment.
Out-of-pocket costs (the gap payment)
In the public system, you won't need to pay anything for your surgery, though there may be some incidental costs. This is the benefit of going 100% public. Private treatment, though offering your choice of surgeon and faster treatment, could see you have some out-of-pocket csots.
How much these costs are vary significantly based on the exact surgery you're going in for. Here are a couple of examples from Medical Costs Finder, the government database of typical out-of-pocket costs for private patients:
Unilateral breast reduction: Typcially $1,000, up to $6,500+
Bilateral breast rexuction: Typcially $8,400, up to $11,000+
Droopy eyelid surgery: Typcially $650, up to $3,100+
Septoplasty (nose reconstruction): Typcially $680, up to $2,100+
To get an estimate of your out-of-pocket costs, you can check Medical Costs Finder, but you should also call your health fund for a more accurate estimate.
Tim Bennett is a Finder insurance & utilities expert. For over 10 years he's reported on news, politics, finance and other topics as a journalist and radio presenter. Tim's roles have included radio news reader and breakfast at the ABC, news producer for SBS and producer for Fairfax Media. Tim regularly appears as a health insurance expert on programs like Sunrise and SBS news, as well as in the Australian, The Daily Telegraph, The Courier Mail and more. See full bio
Tim's expertise
Tim has written 122 Finder guides across topics including:
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 648 Finder guides across topics including:
Accessing treatment from one of your health fund’s preferred providers can help you save money but can also limit your health care choices. Find out more here.
Query: re:Breast reduction surgery when medically needed for health reasons, how does this work regarding costs? I have HAD hospital cover?
Finder
JhezelynMarch 21, 2018Finder
Hi Karren,
Thank you for your comment.
Generally, health insurance covers surgical and accommodation costs under the hospital cover policy if the breast reduction surgery is medically necessary and not only for cosmetic purposes. You may learn more on how insurance cover breast reduction surgery. To compare the policies, you may fill out the form on the page provided and click the “Search Policies” button. Once done, you’ll see the quotes from different health insurance providers with a list of detailed benefits.
Please make sure to read the eligibility criteria, features, and details of the policy, as well as the relevant Product Disclosure Statement PDS/T&C’s of the policy before making a decision and consider whether the product is right for you. If necessary, speak to the insurance brand to verify any details.
Regards,
Jhezelyn
How likely would you be to recommend Finder to a friend or colleague?
0
1
2
3
4
5
6
7
8
9
10
Very UnlikelyExtremely Likely
Required
Thank you for your feedback.
Our goal is to create the best possible product, and your thoughts, ideas and suggestions play a major role in helping us identify opportunities to improve.
Important information about this website
Finder makes money from featured partners, but editorial opinions are our own.
Finder is one of Australia's leading comparison websites. We are committed to our readers and stand by our editorial principles
We try to take an open and transparent approach and provide a broad-based comparison service. However, you should be aware that while we are an independently owned service, our comparison service does not include all providers or all products available in the market.
Some product issuers may provide products or offer services through multiple brands, associated companies or different labeling arrangements. This can make it difficult for consumers to compare alternatives or identify the companies behind the products. However, we aim to provide information to enable consumers to understand these issues.
We make money by featuring products on our site. Compensation received from the providers featured on our site can influence which products we write about as well as where and how products appear on our page, but the order or placement of these products does not influence our assessment or opinions of them, nor is it an endorsement or recommendation for them.
Products marked as 'Top Pick', 'Promoted' or 'Advertisement' are prominently displayed either as a result of a commercial advertising arrangement or to highlight a particular product, provider or feature. Finder may receive remuneration from the Provider if you click on the related link, purchase or enquire about the product. Finder's decision to show a 'promoted' product is neither a recommendation that the product is appropriate for you nor an indication that the product is the best in its category. We encourage you to use the tools and information we provide to compare your options.
Where our site links to particular products or displays 'Go to site' buttons, we may receive a commission, referral fee or payment when you click on those buttons or apply for a product.
When products are grouped in a table or list, the order in which they are initially sorted may be influenced by a range of factors including price, fees and discounts; commercial partnerships; product features; and brand popularity. We provide tools so you can sort and filter these lists to highlight features that matter to you.
Please read our website terms of use and privacy policy for more information about our services and our approach to privacy.
We update our data regularly, but information can change between updates. Confirm details with the provider you're interested in before making a decision.
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
Email me my results (optional)
To get a copy of your results for later, add your email below
Query: re:Breast reduction surgery when medically needed for health reasons, how does this work regarding costs? I have HAD hospital cover?
Hi Karren,
Thank you for your comment.
Generally, health insurance covers surgical and accommodation costs under the hospital cover policy if the breast reduction surgery is medically necessary and not only for cosmetic purposes. You may learn more on how insurance cover breast reduction surgery. To compare the policies, you may fill out the form on the page provided and click the “Search Policies” button. Once done, you’ll see the quotes from different health insurance providers with a list of detailed benefits.
Please make sure to read the eligibility criteria, features, and details of the policy, as well as the relevant Product Disclosure Statement PDS/T&C’s of the policy before making a decision and consider whether the product is right for you. If necessary, speak to the insurance brand to verify any details.
Regards,
Jhezelyn