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.
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.
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.
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 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:
Response | Male | Female |
|---|---|---|
| Hernia and appendix | 3.54% | 2.3% |
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.
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.
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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