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Health insurance for hernia surgery
A hernia can be painful and expensive if left untreated. Luckily, Medicare and private health insurance both cover hernia surgery. Private cover also lets you minimise your waiting time for treatment, reducing the chance of complications.
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*Prices updated October 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.
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Hernia repair can be cover for free under Medicare, but with wait lists of up to a few months.
Private hospital policies that are at least Bronze tier will cover hernia repair.
The cost of private hernia repair without insruance can be over $10,000.
How much does hernia surgery cost?
In the public system, hernia repair is free. However, you'll need to wait for surgery, with waiting lists up to a couple of months long. To avoid that, you'll can use the private system.
If you don't have private health insurance, you could be on the hook for anywhere from $3,000 to over $10,000 for hernia repair, depending on how complex the surgery is, and how long you need to stay in hospital.
If you have a bronze or higher tier hospital policy and have served your waiting periods for hernia repair, most of that will be covered. According to Medical Costs Finder, the average out-of-pocket cost for hernia repair patients with insurance is between $400 and $500. That said, if you need surgery you're best bet is to call your insurer first, to figure out how to minimise the out of pocket costs.
Health insurance that covers hernia surgery
Below are some policies from Finder partners that cover hernia surgery. All quotes are based on a single hospital policy in Sydney with a $500 excess. All include a 2 month waiting period for new conditions, and 12 months for pre-existing. All prices are based on a single individual with less than $97,000 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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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...
When might you need hernia surgery?
Hernias don't go away on their own; they always require surgery. The longer you have a hernia the higher the risk of developing more serious complications. If they're left untreated, you risk needing an emergency surgical procedure.
Does Medicare cover hernia repairs?
Medicare will cover the cost of hernia repair in a private hospital, so you won't have any out of pocket costs. There is a downside though - the waiting periods for hernia repair in the public system can be a couple of months. In the private system, you'll typically only have to wait a matter of weeks for treatment. In the case of a bad hernia, the faster you can have it treated, the better.
Public vs private waiting list for hernia surgery
Public hospital waiting times are not always short. Some surgery waiting lists are a few months long. If you have private hospital cover, you'll generally be able to access shorter waiting periods. Here are the surgery waiting times for hernia surgery from 2015-2016:
Public: 56 days
Private: 25 days
Finder survey: How many Australians have made a hospital claim related to hernia or appendix condition?
Response
Male
Female
Hernia and appendix
3.54%
2.3%
Source: Finder survey by Pure Profile of 1006 Australians, December 2023
How can health insurance help with hernia surgery?
Hernia surgery is classified by most insurers as general surgery. You can find a policy that will include hernia surgery in a basic- to mid-level hospital cover. If you do decide to go private, you shouldn't expect to be out of pocket more than $700 depending on the procedure.
While it costs a little more, having a health insurance policy means you will have greater control over the situation. For many, having access to your own doctor and hospital allows you to relax, knowing you're in good hands. There's also no lengthy surgery queue if you go private. Not only does this reduce the likelihood of complications developing, but it also lets you get back to work sooner.
If you're new to health insurance you may have a one-off 12-month waiting period.
What does a hernia operation involve?
The most common place for a hernia to develop is the groin. If the lump can be gently pushed back through the abdominal wall, it's known as a reducible hernia. If the lump resists any form of pressure, it's a non-reducible hernia. Both require surgery.
The damaged spot in the muscle wall (where a hernia has come through) is repaired by stitching together the edges of the healthy muscle tissue. However, surgical procedures vary depending on the area of muscle wall in need of repair. For instance, special mesh patches are used to repair larger hernias that need to be reinforced.
How long is the recovery time for a hernia?
Hernia surgery is typically a day surgery. A recent report found 80% of hernia patients go home the same day, so you shouldn't have to spend much time in hospital. Recovery time is around three to four weeks.
You can most likely return to light activity after three weeks, though you shouldn't exercise vigorously until around the six-week mark, depending on how you're feeling.
Don't do anything that causes you pain, especially bending over or lifting heavy objects. Remember to rest as much as possible and sit or lie comfortably for the first few weeks.
Finder: What Is Medicare?, https://www.finder.com.au/health-insurance/what-is-medicare Finder: What does Medicare cover?, https://www.finder.com.au/health-insurance/what-is-medicare/what-does-medicare-cover AIHW: Private health insurance use in Australian hospitals 2006–07 to 2015–16, https://www.aihw.gov.au/reports/hospitals/private-health-insurance-use-hospitals/contents/table-of-contents Services Australia: What's covered by Medicare?, https://www.servicesaustralia.gov.au/whats-covered-medicare[/article_source]
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To make sure you get accurate and helpful information, this guide has been edited by Tim Bennett as part of our fact-checking process.
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
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