In Australia, Medicare may cover breast lift surgery, but it depends on specific criteria. Medicare will typically cover a breast lift if it is deemed medically necessary rather than purely cosmetic.
Medicare may cover a breast lift in specific cases, such as:
- Significant Breast Ptosis: If the breasts have significantly lost their position and firmness after pregnancy, breastfeeding, or substantial weight loss, leading to physical discomfort or psychological distress, a breast lift might be considered medically necessary.
- Reconstruction: Medicare may cover a breast lift if it is part of breast reconstruction following trauma, surgery (e.g., mastectomy), or correcting congenital deformities like tuberous breasts.
Breast Lift Medicare (MBS) Item Numbers
To receive a breast lift Medicare rebate, patient’s need a medical referral from their General Practitioner (GP), confirming that the procedure is a medical necessity and Dr Turner will select the right Medicare item number for you.
- Bilateral breast lift – Medicare item number 45558 (surgery performed on both breasts).
- Unilateral breast lift – Medicare item number 45556 (surgery performed on one breast only).
Can I Have a Breast Lift Done in the Public System?
Breast lift surgery is generally not performed in the public health system unless deemed medically necessary and associated with significant health issues. Access to elective surgeries like a breast lift in public hospitals is limited, and waiting times can be extensive. Most patients opt for private surgery to receive timely care and choose their preferred surgeon like Dr. Turner, Specialist Plastic Surgeon.
Why the Big Price Range for Breast Lift Surgery?
The cost of breast lift surgery in Sydney can vary depending on several factors, including the surgeon’s fees, hospital fees, anaesthesia costs, potential implant costs and whether Medicare or private health insurance provides any coverage. On average, the total cost for breast reduction surgery in Sydney can range between $10,000 and $30,000.
Dr Turner’s fees:
Patients seeking Breast Lift
- Privately Insured (eligible for item no) – $8,500
- Cosmetic (not eligible for item no) – $13,500
Patients seeking Breast Lift with Implants
- Cosmetic – $19,500
Costs quoted above are total out of pocket costs – meaning the final cost to patients after rebates (if applicable) are applied.
Do We ‘No-Gap’ Breast Lifts?
Dr Turner does NOT offer ‘no-gap’ breast procedures like breast lift surgery. The private health funds simply do not compensate surgeons, anaesthetists and other medical professionals adequately. This is due to the gap payment which is often less than 30% of what the average surgeon is charging for plastic surgery in NSW, making it impossible to run a modern plastic surgery practice in Sydney.
Will Medicare help fund Breast Lift Surgery?
To qualify for Medicare coverage for a breast lift, you’ll need a referral from your general practitioner or specialist, and the procedure must be performed by a specialist surgeon who is registered with Medicare. If your condition meets the medical necessity criteria, Medicare may cover a portion of the surgery under the relevant MBS item number, such as 45556 or 45558. The Medicare rebate for a breast lift is typically around $1,000. More importantly, being eligible for the Medicare item number is essential to activate your private health insurance, which may cover additional costs like private hospital fees.
Will my private health fund cover my breast procedure?
Your private health funds only cover a breast lift surgery if you meet current Medicare eligibility criteria and has an MBS item number provided by your surgeon. While part of the benefit of private health insurance is that you are eligible for larger surgeon and anaesthetist rebate for your breast lift surgery, the health insurance often covers the private hospital fees. Which in procedures like breast reduction surgery can be over $3,000 – $5,000.
Can I Use My Super Fund to Pay for Breast Lift Surgery?
You may be able to access your superannuation to fund a breast lift if it is deemed medically necessary and you have no other means to cover the costs. The process is managed by the Australian Taxation Office (ATO), and if approved, your super fund will assess and release the funds if appropriate. Accessing your super is a serious decision that can affect your retirement savings, so we recommend seeking financial advice before proceeding. Dr. Turner, Specialist Plastic Surgeon, can provide the necessary medical documentation to support your application.
Next Steps
Always Do Your Research
- Enquire to find out more about your surgery.
- Please read our website to learn more about your intended procedure.
Do you need a Medical Referral to see Dr Turner?
- A medical referral is now required for all medical and cosmetic surgery consultations with a Specialist Plastic Surgeon in Australia due to regulations set out by AHPRA
- Please note that your Medicare Rebates will NOT be claimable without a valid recent Medical Referral.
Making The Most of Your Consultation
- Please arrive early for your in-person consultation.
- You are welcome to bring a friend or relative to help consider the information and discuss your options.
- Ensure you also take a lot of notes during the consultation and thoroughly examine all the documents provided.
How to Book Your Consultation
- You can book your initial consultation by paying the $450 consultation fee in advance – when you make your appointment.
- Contact us or call 1300 437 758 or email us at enquiries@drturner.com.au to arrange your consultation in Sydney with Dr Turner.
