Health insurance for weight loss surgery

How we calculate Health Insurance Hospital Finder Scores

Read full methodology

What different scores mean

9+

Excellent

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.

Health insurance that covers weight loss surgery

Here are a few policies that cover weight loss surgery. All prices are based on a single individual with less than $97,000 income and living in Sydney.

Finder Score - Hospital cover health insurance

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.

Read the full Finder Score methodology

What weight loss surgeries are available?

If a physician recommends weight loss surgery, it will usually be one of the following types.

Lap band (also called gastric banding)

This is where the surgeon wraps a silicone band around the top portion of your stomach, reducing the amount you can fit in your stomach.

Sleeve gastrectomy

This is where the surgeon reduces the size of your stomach by permanently removing a section of it. Like the lap band, this causes you to feel full quicker and eat less.

Gastric bypass

This is where the surgeon divides your stomach into 2 sections, then connects your small intestine to the smaller of the new stomach sections. This helps you to eat less, absorb fewer calories and react negatively to sugar.

Duodenal switch

The surgeon removes a section of the stomach (as they would with a sleeve gastrectomy) and then relocates the bottom of the stomach further down the small intestine. Like the gastric bypass, this procedure causes you to eat less and absorb fewer calories.

Liposuction

In this procedure, the surgeon puts a small tube into your body and sucks the fat out with a vacuum. Liposuction doesn't affect your appetite.

How much does weight loss surgery cost without insurance?

Weight loss surgery costs without insurance differ depending on how much the surgeon, anaesthetist and assistant charges, pathology costs and the type of procedure you undergo. Here's an overview of surgery costs in Australia based on a number of health providers we looked at.

To help lower these costs, make sure you get the Medicare Benefits Schedule (MBS) number for the type of surgery you require. Don't expect it to significantly lower the costs, though. For example, Item 31575 (sleeve gastrectomy) pays a $663 benefit. Some useful item numbers for weight loss surgery are outlined below.

See MBS item numbers for weight loss surgery

Can anyone get weight loss surgery?

No, it's not always possible for anyone to get weight loss surgery. This is because it's not always the best course of action for everyone. It also depends on whether you receive treatment through the public system or privately.

Medicare

To be eligible for treatment in the public system (Medicare), you need to have a body mass index (BMI) of at least 35, demonstrate that you've failed using other approaches and you'll have to undergo a psychological evaluation. You'll also have to find a public hospital that will do this sort of treatment, and there are only a few in Australia.

Private health

Private health insurers will require you to have a face-to-face consultation with a physician to determine if the surgery is necessary, and some insurers require you to have a BMI above a specific number. However, these requirements are less restrictive than Medicare and you will have more choice of hospitals.

Cover for weight loss surgery vs weight management

Cover for weight loss surgery

You'll only find health insurance for weight loss surgery with a gold-tier hospital policy. If you're not already on one, you'll want to get on one soon because there will be a waiting period, usually around 12 months.

Cover for weight management

Many extras policies cover weight management programs such as fitness classes, money off gym memberships and nutritional consulting programs such as WW (previously Weight Watchers) and Jenny Craig. This can give you a chance to learn new wellness habits pre-surgery or, in some cases, avoid having surgery altogether. Waiting periods are a lot shorter – usually around 2 months.

FAQs

• What's the cheapest health insurance for weight loss surgery in Australia?

  As of December 2024, Mildura Health Fund offers the cheapest gold hospital policy, at $39.25 per week. Only gold policies will cover weightloss surgeries.

• Can weightloss surgery be covered by insurance?

  Yes, it's a legal requirement in Australia for all gold-tier hospital policies to cover weight loss surgery.

• Does Medicare cover weight loss surgery?

  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.

• Can I get free weight loss surgery in Australia?

  It depends. Medicare can cover medically necessary weight loss surgery but there could still be out of pocket costs if treatment needs to take place at a private clinic.

• How much is weight loss surgery without insurance?

  It depends on what you need done but our research shows weight loss surgery without health insurance can cost upwards of $20,000.

• Are there waiting periods for weight loss surgery?

  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.

• Will health insurance cover ozempic for weight loss?

  No, health insurance will not cover the cost of ozempic use for weight loss reasons.

• Is bariatric surgery the same as weightloss surgery?

  Bariatric surgery may be used interchangeably with weightloss surgery. Both can refer to a variety of procedures aimed at weight management.

To make sure you get accurate and helpful information, this guide has been edited by Angus Kidman as part of our fact-checking process.

Written by

Gary Ross Hunter

Editor, Insurance

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 644 Finder guides across topics including:

• Health, home, life, car, pet and travel insurance
• Managing the cost of living

Co-written by

Peta Taylor

Publisher of Insurance

Peta Taylor is a publisher at Finder, working across all of insurance. She's been analysing product disclosure statements and publishing articles for over 2 years. Peta is passionate about demystifying complex insurance products to help users make well educated decisions with confidence. Peta is part of Finder's insurance awards team and works alongside editorial and insights experts to bring users the best insurance products every year. See full bio