The answer to the question, will Medicare cover breast reduction/lifting surgery, varies. MBS codes and Medicare rebate criteria change frequently for plastic surgery operations, including breast reduction surgery. Join us as we discuss what this means for you.
Does Medicare Still Cover Breast Reduction Surgery in Sydney?
MBS changes may require additional photographic proof, examination evidence, reporting documentation, and stricter patient criteria for Medicare rebates for breast reduction/lift surgery. This includes breast lift surgery to treat breast ptosis after pregnancy. Other procedures impacting women’s health were also subject to change. Medicare codes and rebate eligibility criteria for breast surgery procedures can may change in an instant.
Medicare Criteria and Breast Reduction Lift Surgery
If you meet the current Medicare criteria and required documentation as proof for your breast operation then you may qualify for a small rebate from Medicare for your breast reduction or lift surgery. However your eligibility may depend on your degree of breast ptosis or breast deformity. It may also depend on the age of your youngest child and/or how your heavy, ptotic breasts impact your physical health. This includes things like back pain or chronic skin infections.
Further, you may also be eligible for surgery from your private health insurance provider. However you will need to check directly with your chosen health fund about your policy. Your private health fund cover for breast reduction will only apply if your condition meets criteria for a Medicare item code or MBS rebate.
Part of Medicare Criteria for Breast Lift is the Age of Your Youngest Child
Your youngest child must be at least 12 months in age but not older than 7 years of age (subject to change).
Can I Use My Super Fund for Breast Reduction Surgery?
Patients may be able to request early withdrawal or superfund release to help pay for reduction surgery. Each application for early super release is assessed on an individual basis. Further, tax implications may apply, so we recommend seeking professional financial advice. Super fund withdrawal applications can be made through your MYGOV account via the ATO (subject to change).
What Are the Time Restrictions for Rebate Coverage for a Breast Lift?
If your youngest child is approaching the age of 7, you may run out of time to claim a Medicare rebate on Breast Lift after pregnancy. That is due to the age and time related eligibility criteria for MBS item codes for breast reduction after pregnancy.
Not Eligible for Medicare Rebate or Health Fund Coverage?
How much will breast reduction surgery cost?
The cost of breast reduction surgery in Sydney by a plastic surgeon can vary. That’s because your surgeon fully customises the procedure to meet your individual lift, shape and reduction needs, including whether you require additional liposuction.
Contact Dr Drielsma’s team today to discuss our eligibility for Medicare rebates, as well as visiting your general practitioner or other specialists to ask for a referral.
Meet Our Plastic Surgeon
"The best choice a patient
can make is one that leads
to their own happiness"
MBBS, BSc(Med), FRACS
(AHPRA MED 0001073756)
Dr. Robert Drielsma
MBBS (Hons), BSc(Med), FRACS (AHPRA MED 0001073756)
Dr Drielsma is an Australian trained fully qualified Specialist Plastic and Reconstructive surgeon specialising in aesthetic surgery of the face, breasts and body.
His medical degree, (M.B.B.S Hons) was completed with honours at the University of Sydney in 1982. During this time he also completed a Bachelor of Science degree. Dr Drielsma then completed specialist training in both general surgery and plastic surgery in Sydney attaining fellowship of the Royal Australian College of of Surgery (FRACS) in both disciplines. Further training and experience was then attained internationally in London, England and Toronto Canada.
Dr Drielsma commenced his private practice in Canberra and Sydney Australia in 1997. His practice is now based in Bondi Junction, Sydney and incorporates Camden in Sydney’s west, Wagga Wagga and Canberra.
Dr Drielsma is a Fellow of the Royal Australasian College of Surgeons (FRACS), member of the Australasian Society of Plastic Surgeons (ASPS) and member of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS). Dr Drielsma is also board Certified by the Australian and New Zealand Board of Cosmetic Plastic Surgery.
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