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Can I claim a tummy tuck from Medicare?

Tummy Tucks / Medicare

30 Mar 2022

Tummy tuck from Medicare?

Have you decided it’s time for a change? Have you been battling with excess skin and muscle separation, either as a result from children or weight loss?

And, so now you find yourself Googling, “Can I claim a tummy tuck from Medicare?”


Can I claim from Medicare?

In short – there are no public hospitals offering free tummy tucks in Newcastle.

However, Medicare will provide a modest rebate if you satisfy the weight loss or muscle repair criteria.

Importantly, having Medicare coverage is key to having health fund coverage, which reduced the overall cost from $26,200 out of pocket to $18,800 when you choose Dr Moncrieff for your tummy tuck.


What do you have to demonstrate to get a Medicare number for a tummy tuck?

For weight loss patients - for Medicare item number 30177 to apply you must demonstrate:

  • That you have had significant weight loss defined as 5 BMI points or more (unrelated to pregnancy). This mean women who have experienced a weight loss of at least 15kgs or more, without weight fluctuations for at least 6 months,
  • The level of excess skin is interfering with daily living,
  • The use of non-surgical treatment for skin irritation caused by excess skin has failed to work,
  • If you have a hernia which can be documented in an ultrasound – it can also assist in seeking coverage.


Muscle repair after pregnancy patients - for the new Medicare item number 30175 announced in the 2022 Budget and due to commence on 1 July 2022 (see more information about this here) to apply you must demonstrate:

  • it is more than 12 months after the end of a pregnancy,
  • you have a diastasis (muscle gap) of at least 3cm measured by diagnostic imaging, and
  • have documented symptoms of at least moderate severity of pain or discomfort at the site of the diastasis in the abdominal wall during functional use and/or low back pain or urinary symptoms likely due to rectus diastasis; and
  • have failed to respond to non-surgical conservative treatment including physiotherapy


All of the above should be discussed with your referring GP and documented in their referral to us. If you provide a referral, Medicare will provide you with a rebate of just over $75 from our initial consultation fee of $350.

For more details on our fees and the criteria Medicare use to determine if you can have a rebate, visit our tummy tuck page.


What does a tummy tuck with Dr Moncrieff cost?

Please see our tummy tuck page for full out of pocket cost details for both insured and uninsured patients.

 

What should you ask when you are considering your tummy tuck options?

These are some questions you might like to ask when looking at different options. My answers apply to the following:

  • Is this surgeon a genuine Plastic Surgeon? Understanding this question is crucial. This means have they completed at least 14 years of training and examinations, or even more as I invested 17 years in my training and fellowship before opening Hunter Plastic Surgery in 2009. This contrasts with the term ‘cosmetic surgeon’ which anyone with a basic medical degree can use.
  • Will you be operated on in a fully accredited hospital? Yes.
  • Will a Specialist Anaesthetist administer you a full general anaesthetic? Yes.
  • How many of this type of procedure has the surgeon performed? Over 500 women in Newcastle.
  • Can you view lots of before and after clinical photos? Yes – on this website and on social media.
  • How well are the risks and recovery process explained? We have information on our website, as well as comprehensive information provided during your consultation and to take home to consider afterwards.
  • Are there after care services offered? All patients see both my Practice Nurse Alecia for post-operative support and myself for ensuring support throughout your recovery. It is our focus on patient care that has seen us win 23 awards for our service in the last few years.

 

Are there other options to consider as an alternative?

CoolSculpting:  offer a non-invasive option when it comes to reducing bulges on the tummy, love handles and other areas of the body. CoolSculpting is a viable option for those wanting to reduce fat layers on the body. However, this kind of treatment is not suitable for those with excess skin and it does not address underlying muscle separation. For more information, you can visit our CoolSculpting page.

Liposuction: Again, this can reduce bulges, but does not tighten skin, which is what most patients we see looking for a tummy tuck are wanting. Dr Moncrieff only offers liposuction in conjunction with other surgical procedures.

 

Ready to book a consultation?

Please call our lovely team on 4920 7700 or send us a message below. We also have two team members who had tummy tucks with Dr Moncrieff before they applied for roles with us who are happy to talk you through the surgical journey!


Related pages:

How much does a tummy tuck cost?

Tummy tuck page

Mummy makeover page

How can I tell if I have muscle separation? 

Dr-Moncrieff dr-nicholas-moncrieff-at-charlestown-private-hospital-22

Blog Author:

Dr Nicholas Moncrieff, Specialist Plastic Surgeon, Newcastle NSW

About Dr Moncrieff

Dr Moncrieff focuses exclusively on breast reductions, breast lifts, breast augmentation, tummy tucks and body lifts.

He is one of only a handful of Cosmetic Plastic Surgeons across Australia with this sole breast and body focus.

Dr Moncrieff has performed thousands of surgical procedures over more than two decades in medicine. Over 20,000 of these procedures have been in Newcastle.

More information about Dr Moncrieff is available here.

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