What am I covered for if I have Private Health Insurance?

As Medicare and the public hospital system does not currently cover bariatric surgery, it is recommended that patients are privately insured. This means that you will be able to claim a range of medical services including your hospitalisation in a private hospital with the minimum of fuss and out of pocket expenses. 

If you are not privately insured however there are ways that you may be able to access funding and you will need to talk to your surgeon about this.

What questions to ask before you decide to go ahead?

There are a number of questions you should ask before you decide to go ahead with Lap-band® Surgery. These include:

  1. Are you currently insured by a private health insurer?
  2. Does your level of cover include bariatric surgery?
  3. Has the 12 month waiting period for coverage passed?

Once you have decided to proceed with the surgery, the Hobart Obesity Surgery Centre will charge a fee covering the surgical components of the Lap-band® System. You will need to pay this fee before you commence the program. You may claim a percentage of these fees from both Medicare and your private health insurer and we recommend you check the rebate structures with them early in the process.

As part of your individual weight loss program, your surgical team may also recommend you see other health care professionals including a dietitian, a psychologist, have sleep studies, and so forth and these fees will be in addition to the surgical fee. Again, you will need to check with Medicare and your private health insurer regarding rebates and we will provide you with Item No’s at your first consultation.

What if I don’t have private health insurance?

If you do not have private health insurance and still wish to go ahead with the program your surgeon will provide you with a ‘global fee’ covering a range of services and you may wish to pay in one of the following ways:

  • Cash payment
  • Medical loan that can be paid off in 12-24 months
  • Possibility of access to superannuation funds

You will still be eligible for the appropriate Medicare rebates on the cash payment scheme however you will be responsible for the private hospital and other ancillary costs not normally covered by Medicare. You will need to carefully investigate this option thoroughly with the relevant financial bodies and professionals before you make your decision to go ahead.

© Dr Tony Patiniotis - Hobart Obesity Surgery Centre, Tasmania, Australia