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What is medicare?
Medicare provides access to medical and hospital services for all Australian residents and certain categories of visitors to Australia. We administer Medicare and pay Medicare benefits on behalf of the Department of Health, which is responsible for developing Medicare policy.

Medicare covers:

free or subsidised treatment by health professionals such as doctors, specialists, optometrists – and in specific circumstances – dentists, and other allied health practitioners
free treatment and accommodation for public Medicare patients in a public hospital
75% of the Medicare Schedule fee for services and procedures if you are a private patient in a public or private hospital – this does not include hospital accommodation and items such as theatre fees and medicines
We pay Medicare benefits in accordance with the legislation governing Medicare and we are not able to pay benefits outside of this legislation.

In Australia, all plastic surgeons registered with the Australian Society of Plastic Surgeons are recognised by Medicare. To receive a Medicare rebate, individuals must ensure they receive a referral letter from their general practitioner to attend the specialist. Medicare will only provide a rebate to patients who were referred to the specialist by a general practitioner. In addition, individuals should be aware that plastic surgery is only covered by Medicare when it is medically indicated (that is when it is necessary for health and not only cosmetic reasons).

Some procedures are considered to benefit a medical condition and will correspond with a Medicare Benefits Schedule (MBS) item number. This item number is listed on your surgical receipt and allows patients to claim a rebate for the surgeon’s fees, anaesthetist’s fees, approved implants/prostheses and some assistant fees.

If you have private health insurance, and your procedure has an MBS item number, patients may be able to claim a further rebate. You will need to check your level of cover with your private health insurer.

Your rebate can only be claimed after surgery. The difference between your initial fees and any rebates received are called out-of-pocket expenses.

You can claim a tax offset of 20% for medical expenses over $1500, minus any rebates received from Medicare and private health insurance.

There is no limit to the amount you can claim. However, it does not apply to cosmetic procedures, which don’t attract an MBS item number.

For more information, please call your financial advisor or the Australian Taxation Office

*Bilateral Breast Reduction (Item no. 45520) – Medicare Rebate is $675.35
*Tubular Breast Reconstruction (Item no. 45559) – Medicare Rebate is $852.60
*Abdominoplasty (Item no. 30177) – Medicare Rebate is $739
*Breast Augmentation for asymmetry (Item no. 45524) – Medicare Rebate $556.25
*Breast Implants for breast deformity (Item no. 45528) – Medicare Rebate $834.30
*Breast Lift for Asymmetry (Item no. 45556) – Medicare Rebate $574.55
*Breast Lift after pregnancy – (Item no. 45558) – Medicare Rebate $861.75
*Breast Augmentation- No medicare rebate available

All rebate prices are set to change at any time, you would be best in talking with your surgeon when you have your consultation to see what you would be eligible if you’re entitled to any.

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Kaz Louise
Good post
  • September 11, 2016
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