Is It Your Choice? And What Is the Difference?
Planning for plastic surgery raises many questions for patients about what the process will look like, and what decisions they will need to make. Patients often wonder if their plastic surgery should be performed in a public hospital, or a private hospital.
While there is no “one size fits all” answer to this question, there are some key factors to be taken into consideration when making this decision.
Plastic surgery is usually an elective procedure, meaning that it is non-emergency. In Australia, elective plastic surgery procedures can be performed at both public and private hospitals by Specialist Plastic Surgeons. A private hospital is managed and owned by private organisations, and fees are paid by patients, or subsidised by private health insurance.
Private or Public Hospital – What Does the Difference Mean for Me?
In a public hospital, patients will be able to access more services during and after surgery. This is especially important for patients who are at risk of complications, such as:
- Those who have underlying medical conditions or complex health issues
- Patients who live rurally
Plastic surgeries performed through the public system can sometimes be covered by Medicare, if the surgical procedure has an item number that fits Medicare’s criteria. If you fit these criteria, you will only have to pay a part of the fee for the surgery. This amount varies depending on what surgery you are having.
The main benefit to private plastic surgery is the increased choices that you are able to make about your surgery. This allows you to have a lot more control over the entire surgical process, from selecting a surgeon, to booking the surgery date.
Private plastic surgery patients are able to choose:
- The surgeon that they would prefer to perform the surgery
- The time and date of their surgery
Many private plastic surgery patients will choose to travel out of state to have their surgery done by a specific surgeon. Looking at online galleries of surgical results, reading testimonials, and consultation with multiple different surgeons allows you to make a well-informed decision on who will perform your surgery. If you have travelled from out of state, you will need to attend post-op check-ups with your surgeon in person.
When undergoing plastic surgery in a private hospital, there is usually a shorter wait time for surgery. Patients in private hospitals often have their own room, and can access additional resources such as free parking and improved catering.
What are the Benefits of Having Plastic Surgery in a Private Hospital?
- Shorter wait times for surgery
- Increased flexibility
- Choosing which surgeon performs the surgery
- Choosing the date when the surgery will be performed
- Able to stay in a private room
- Peaceful, quiet environment for recovery
- Additional benefits such as free parking and free Wi-Fi
What are the Drawbacks of Having Plastic Surgery in a Private Hospital?
- Increased costs when procedure is not covered by insurance
- Reduced access to emergency resources
What are the Benefits of Having Plastic Surgery in a Public Hospital?
- Some procedures are free of charge if you have a Medicare number
- A wider range of healthcare services are accessible to you and your medical team
- Equipped to manage complex medical cases
- Access to emergency care if needed
- Reduced costs when compared to private care
What are the Drawbacks of Having Plastic Surgery in a Public Hospital?
- You will have to share a room with other patients
- You will have reduced control over your surgery
- Not able to choose which surgeon performs the procedure
- Not able to choose what hospital the procedure is performed in
- The time, date and wait time of surgery is determined by the availability of the surgeon
Will the Length of My Hospital Stay after Plastic Surgery Be Different If I’m In a Private Hospital?
The length of time you will need to stay in hospital after your plastic surgery depends on factors such as:
- Your age and activity level
- Your health and medical history
- What procedure you are having
This means that your length of stay will most likely be the same in either a public or private hospital.
During your consultation, your surgeon will explain the expected recovery time for your plastic surgery procedure, including how many nights you will have to spend in hospital. Sometimes, this can change post-op if there are any complications.
Is There Still a Wait Time for Plastic Surgery in a Private Hospital?
While the wait time for private plastic surgery is often shorter than public plastic surgery, there is still a mandatory waiting period after consultation. There is a minimum of 7 days after the consultation before surgery can be performed, but this period might be longer for some patients.
The waiting period gives patients time to:
- Make plans for surgical recovery
- Organise childcare and pet care if necessary
- Review information about the surgery
- Get a second opinion if desired
- Stop taking supplements and medications that increase risk of complications
- Emotionally prepare for plastic surgery and surgical recovery
However, you are usually able to make the decision to reserve your surgery date immediately after your first consultation. It is best to book as soon as possible, as some surgeons can have wait times of up to six months for popular procedures or certain times of year.
What date you are able to book for your plastic surgery will depend on:
- If your plastic surgery is going to be covered by insurance
- If your procedure is medically necessary
- What type of preparation is needed for your procedure
- If you are booking for a busy time of year for plastic surgeons, such as:
- The beginning of the school holidays
- Over Christmas
- During winter
If I Have my Plastic Surgery in a Public Hospital, Will Costs Be Covered by Medicare?
If you live in Australia and have a Medicare number, you are automatically entitled to receiving free medical care in public hospitals. Many patients are hopeful that Medicare will cover their plastic surgery costs and provide them free care in a public hospital before, during, and after their plastic surgery procedure.
Medicare does NOT cover cosmetic surgery under any circumstances, and will only cover plastic surgery if it meets the following criteria:
- Considered to be essential reconstructive surgery, such as:
- Reconstruction after trauma, such as severe burns or following a car crash
- Breast reconstruction following breast cancer
- Tissue transfer or restorative surgery after amputation
- Plastic surgery after removal of tumours or skin cancer
- Surgery following significant weight loss to correct excess skin
- Surgery to repair congenital/developmental deformities, such as:
- Rhinoplasty to correct nasal passage deformities and obstruction
- Removal of excess eye tissue to improve vision
- Repair of a cleft palate or cleft lip
- Correction of breast developmental disorders that have a significant impact on quality of life
Your surgeon will be able to tell you whether or not your procedure will be covered by Medicare, or you can search the Medicare Benefits Schedule for your procedure to see if it has an item number. The Medicare Benefits Schedule is often updated, so it is best to search for an up-to-date version to check if your procedure can be covered.
So, Medicare Doesn’t Cover Cosmetic Surgery… How Do I Tell the Difference Between Cosmetic Surgery, and Plastic Surgery?
While many people believe that cosmetic surgery and plastic surgery are one and the same, there are many differences between cosmetic plastic surgery, and reconstructive or essential plastic surgery. Cosmetic surgery is sometimes called cosmetic plastic surgery.
Cosmetic plastic surgery is:
- Elective, meaning that the patient chooses to have the surgery
- Not currently recognised as a specialty practice by the Medical Board of Australia
- Able to be performed by a plastic surgeon OR a cosmetic surgeon
- Any doctor with a medical degree is qualified to perform most cosmetic surgeries without further training
- Not considered to be medically necessary for the patient’s health or function
- Designed to enhance the body’s features for aesthetic purposes, such as rhinoplasty for a smaller nose, breast augmentation, and facial implants
- Never covered by Medicare
Plastic surgery is:
- Sometimes essential for body function and well-being
- Plastic surgery includes reconstructive surgery after injury, trauma or cancer
- Plastic surgery can also be cosmetic
- Always performed by a Specialist Plastic Surgeon, who has:
- A minimum of 5 years of specialist training
- A specialist qualification recognised by the Australian government
I Think I’m Eligible for Medicare Cover for Plastic Surgery – What Do I Do Next?
Your first step should be to ask your GP to send a referral letter to a Specialist Plastic Surgeon. Medicare will only cover plastic surgeries that are performed by a FULLY QUALIFIED and ACCREDITED plastic surgeon. Surgeries performed by cosmetic doctors will not be covered.
A referral from a GP can sometimes allow patients to claim a rebate back from Medicare for the initial consultation.
It is important to remember that:
- You will need to have a valid Medicare referral to have your surgery covered by Medicare
- GP referrals are only valid for a 12-month period
- Specialist referrals are only valid for a 3-month period
If you have any concerns or questions during this process, make an appointment with your GP or call your plastic surgery office for guidance.
Can My Plastic Surgery be Covered by Private Health Insurance?
While private health insurance is often used for fees not covered by Medicare, most health insurance policies do not cover cosmetic procedures. However, private health insurance can cover some of the costs of plastic surgery if the procedure is medically necessary.
If you do use private health insurance for plastic surgery, you will usually need to pay an excess. This means that even if your private health insurer approves your plastic surgery claim, you will still have to pay a percentage of the costs. These costs vary depending on what procedure you are having, as well as who your insurance provider is.
The Australian Prudential Regulation Authority’s statistics show that people with private health insurance pay, on average, between $460 and $2800 in out-of-pocket costs for insurance-covered plastic surgery procedures.
Can I Have My Plastic Surgery as a Private Patient in a Public Hospital?
There is sometimes an option to go to a public hospital for your surgery while remaining a private patient, depending on location, urgency, and surgeon availability. Your doctor or surgeon will be able to inform you if this is possible in your case. Some considerations when being a private patient in a public hospital are:
- Some out-of-pocket costs will still need to be paid. These costs will vary depending on the procedure and your insurance
- Public hospital waiting lists will still apply to you, even if you are a private patient. The length of the waitlist depends on what surgery you are having, and what area of Australia you live in
If I Don’t Have Private Health Insurance, Can I Still Be a Private Patient?
Yes, you are able to go to a private hospital for plastic surgery even if you don’t have private health insurance, or if your insurance will not cover your plastic surgery procedure. You will be able to enjoy all of the benefits of having your plastic surgery in a private hospital, and will be treated the same as a patient with private health insurance.
The costs for private hospital treatment will not be covered by Medicare, so it is recommended to research the costs ahead of time.
Out-of-pocket costs will include:
- Fees for an overnight stay
- Fees for a private room
- Anaesthesia costs
- Medication, such as pain relief and antibiotics
- Any necessary medical imaging
- Surgical theatre fees
- Post-op garments, such as compression garments
Further Reading about Funding Your Plastic Surgery and Medicare
- Standard Search | Medicare Benefits Schedule
- Will Medicare cover my surgery? – Dr Michael Kernohan
- Dr Carmen Munteanu – Melbourne Plastic Surgeon for Cosmetic Plastic Surgery
- About Us – Dr Bish Soliman – Soliman Plastic Surgery Sydney
- Plastic Surgery Risks and Complications
- Dr Jake Lim – Does Medicare Cover Breast Reduction Surgery?
- Cosmetic Surgery Cheshire – Anca Breahna