I need a boob job, can Medicare help? – Medicare for Breast Surgery

I need a boob job, can Medicare help?

I need a boob job, can Medicare Help? If you are considering a breast surgery this is something you may be interested to know; many cosmetic procedures (in which some breast procedures are included) have a Medicare rebate when performed by a specialist Plastic surgeon.

Even if you don’t have private health insurance the Medicare rebate may be available to you if you meet the criteria and when the breast procedure is performed by a Specialist Plastic Surgeon.

Breast Augmentation is mostly NOT covered by Medicare except in very specific circumstances like congenital deformities (some tuberous or asymmetric breasts) or some reconstruction after cancer.

A Boob Job may be covered by Medicare when it is part of a reconstruction after a mastectomy or other breast cancer treatments. Minor Medicare rebates may in a few cases be available if you have recurring health issues because of the size, position or skin condition of your breasts. So, the popular question of “I need a boob job, can Medicare help?” might not necessarily have the answer that you want.

But not all procedures are covered by a Medicare rebate for example if you are looking for a breast augmentation for purely aesthetic or cosmetic reasons you will probably find that NO insurance company will cover ANY  of the cost. However if you need breast surgery procedures for any of the following make sure you check the Medicare rebates listed below, as Medicare may cover some of the costs.

Strict Conditions apply!

Medicare Item Numbers for Breast and Tummy Surgery

  • Breast Augmentation for cosmetic purposes has No Item no – Medicare Rebate NIL
  • Bilateral Breast Reduction (Item no. 45520)
  • Tubular Breast Reconstruction (Item no. 45559)
  • Breast Augmentation for asymmetry (Item no. 45524) – Medicare Rebate $556.25 (1 side)
  • Breast Implants for breast deformity (Item no. 45528) – Medicare Rebate $834.30 (1 side)
  • Breast Lift for Asymmetry (Item no. 45556) – Medicare Rebate $574.55 (1 side)
  • Breast Lift after pregnancy –  (Item no. 45558) – Medicare Rebate $861.75 (both sides)
  • Tummy Tuck or Abdominoplasty (Item no. 30177 – weightloss and 30175 – post pregnancy)

You will need a valid Medical Referral from a GP or Specialist to claim these rebates.

Of course, you must talk about these rebates and the details with your Plastic Surgeon before you make your final decision on your surgery. The rebate and the quality of the procedure are just reasons why you should use qualified Plastic Surgeons for any of your major plastic surgery procedures.

For more information on how to know the correct qualifications your surgeon should have – look for FRACS, ASPS, ASAPS or ISAPS membership

To check any Medicare item the rebate for it and any further details head to www.health.gov.au and MBS Online for Medicare Item Numbers Details

Also if you have any further questions don’t hesitate to contact us at [email protected]

Further Reading about a Boob Job in Australia