What is health insurance cover for weight loss surgery?
Health insurance cover for weight loss surgery, also called bariatric surgery, refers to a specific policy that helps pay for some or all of the costs associated with the procedure. Many insurers offer policy options that cover one or more forms of weight loss surgery. When you schedule the procedure, you may be able to claim part or all of the cost on your health insurance, minus any excess you are required to pay.
What fees does health insurance for weight loss surgery cover?
If you've taken out a policy that covers you for weight loss surgery, you'll generally receive cover for pre-operative assessments, your hospital stay, the procedure itself and certain post-operative support. In Australia, these services fall under the Gold tier of hospital cover, or potentially a Silver Plus policy that specifically adds weight loss surgery as a clinical category. Keep in mind you may still face out-of-pocket costs, such as fees from your anaesthetist or surgical assistant, as well as some medications and services not included in your policy.
Some weight loss surgeries may be partly covered by Medicare as part of Australia’s public health system. However, public hospitals may have lengthy waiting lists for these treatments, and you may still need to cover some out of pocket expenses.
Some of the costs covered by private health insurance may include:
Hospital costs: This generally includes your hospital stay, theatre fees, surgical equipment and any tests carried out while you’re admitted.
Surgeon and anaesthetist fees: Medicare and your health fund will typically share the cost of these services, although out-of-pocket costs may still apply.
Pre-operative assessments: This may cover initial consultations with dietitians, psychologists or other specialists required before surgery.
Post-operative support: Some policies offer benefits for follow-up appointments with your surgeon or dietitian for a set period after the procedure.
Health insurance cover for weight loss surgery explained
What is weight loss surgery?
There are several different types of weight loss surgery available in Australia, including but not limited to:
- Lap band surgery (laparoscopic adjustable gastric banding): An adjustable silicone band is placed around the top part of your stomach, creating a small stomach pouch above the band that helps you feel more satisfied after eating a smaller amount of food.
- Gastric sleeve surgery: Removing most of your stomach so you can feel more full after eating a smaller amount of food. Hunger is also reduced as your smaller stomach produces less hunger hormones.
- Gastric bypass surgery: A small part of your stomach is connected directly to your small intestine. Because food can now bypass most of your stomach, you may feel full sooner, your body absorbs less of what you eat, and the feeling of hunger is reduced.
Each of these surgeries has its own advantages and disadvantages, potential risks and rewards. This is in addition to the potential risk involved with undergoing general anaesthesia and surgery.
The best weight loss surgery for you will depend on a wide range of factors, from your physical health to your eating habits and lifestyle. Talk to your doctor for medical advice.
Is weight loss surgery covered by Medicare?
Some weight loss surgeries such as bariatric procedures can be covered by Medicare, which could minimise some of your expenses as you’d be financially supported by Australia's public health system. However, because Australia’s public hospitals prioritise treatments based on urgency, elective procedures such as weight loss surgeries could require you to join a lengthy waiting list. Your surgery could potentially be prioritised higher if doctors determine that your weight poses an immediate risk to your health.
How to find the best health insurance for weight loss surgery
There's no one 'best' health insurance policy, as different households have vastly different needs, including weight loss surgery. But knowing how to compare health insurance, and which features or policy types will benefit you the most, can help you find the best deal.
If you’re specifically looking for health insurance that covers weight loss surgery, you may want to focus your research on the Silver Plus and Gold policy tiers, as these are more likely to offer more extensive health cover, including weight loss surgery. When you're searching for policies that need to include a specific product, always check the policy documentation or contact the insurer to be certain of what you may be covered for before you apply.
Consider comparing policies from different insurers, as you may receive different levels of value from your premiums, depending on the features and benefits on offer. There may also be extra introductory offers, discounts or deals that could affect your choice. Comparing policies with Canstar can help take the guess work out of choosing a policy that best suits you. Use Canstar’s free comparison tool online or call our team on 1300 383 982 to speak with one of our health insurance experts.
