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Friday, September 13

Will my private health fund pay for body contouring plastic surgery after massive weight loss?



Will I be able to use my private health fund for body contouring surgery after massive weight loss?

Dr Eddie Cheng, Brisbane Plastic Surgeon, explains the 4 key eligibility criteria for the use of private health insurance and medicare for post weight loss plastic surgery such as tummy tuck, arm lift, thigh lift, lower body lift, breast reduction/breast lift. 

In order to qualify for medicare and private health fund rebates you need to fulfill four key criteria.

Criteria #1 - Weightloss of 5 BMI points or more

You need to lose at least five BMI points and for an average person, you'll need to lose at least 15 kilograms. Keep in mind that your weight during pregnancy cannot be included in weight loss .

Criteria #2 - 6 Months of stable weight

You need to demonstrate that you have been able to maintain this weight loss by keeping a stable weight for least 6 months.

Criteria #3 - Skin conditions

You need to have skin conditions such as rashes or chaffing, which have been treated for a minimum of 3 months using non surgical methods like cream and showing minimal improvement.

Criteria #4 - Interference with activities of daily living 

You can demonstrate that all this excess skin from weight loss has been affecting your activities every day including exercising.

If you meet all these criteria and would like to see a specialist plastic surgeon, make sure that you see your GP for a referral that outlines how you meet these 4 criteria.  This is especially important if you wish to use your private health insurance.  You should also make be sure that your level of private health cover falls within the gold tier category also. If you enjoy all this information, make sure that you follow us on Instagram and Facebook @arplasticsurgery or subscribe to my youtube channel AR Plastic Surgery.

What if I have not lost weight but have had children?

Unfortunately Medicare and Private Health Insurance currently DO NOT provide cover for postpartum or after pregnancy muscle separation without any weight loss. If the above criteria are not met then tummy tuck surgery and other body contouring surgery is considered cosmetic.  

Want to learn more?

You can learn more about Body Mass Index BMI and plastic surgery as well as calculate your BMI here.

Dr Eddie Cheng is a board certified Specialist Plastic Surgeon in Brisbane, Australia.  Socialise with us @arplasticsurgery to learn more about Dr Eddie Cheng and our Team.



Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

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