For Private patients undergoing any operation in a private hospital do not have to pay any hospital expenses, as these are covered by their health fund. Some health funds will charge an excess which vary from $0 to $500 depending on your fund and level of cover. Often a 12-month waiting period will apply before you can use your health insurance.
It is recommended to check with the health fund whether or not you are covered for bariatric surgery. The common item numbers we use are:
- Gastric Sleeve: 31575
- Gastric Bypass: 31572
- Gastric Band removal: 31585
- Revision Surgery: 31584, 30724
You will be charged a single expense for the surgery. This fee covers:
- Surgeon’s fee for the procedure
- Follow up appointments for 12 months
There will be an out of pocket costs for the common weight loss procedures but if any additional consultations or operations are required from problems that may arise from the procedure, there will be no further charge.
Anaesthetic expenses
These will vary according to the type of operation, the length, and any medical co-morbidities you have. We have a close working relationship with a group of anaesthetists experienced in the specific medical problems of obesity. Your anaesthetist will contact you prior to the operation and you can discuss specifics of payments then. Often the charges will be of the range $600-$1800 which are partially rebatable.
Other costs
You will be required to commence a low calorie meal replacement diet (Optifast) for 2 weeks prior to the operation. You will need to pay for these meal replacements. They are generally available at a pharmacy and cost approximately $150 for 4 weeks.
If we arrange for you to see any other specialists prior to your surgery, such as endocrinologists, cardiologists, or respiratory physicians they may charge you for these visits.
There may be additional costs such as blood tests or x-rays required before or during your stay, depending on your health fund.
Reasons for GAP payments
Unfortunately, the full costs involved in providing quality medical care are not adequately covered by medicare. Most common surgical procedures performed by experienced surgeons in the private health system involve a gap payment. Weight loss surgery has even more costs, as multiple professionals are involved in your care.
Not Privately insured
If you do not have private insurance, the expenses of weight loss surgery will depend on the specific procedure, equipment used, the cost of the prosthesis, theatre fees, Surgeon’s fee, Assistant fee, Anaesthetist’s fee, Intensive care fees if this is required, the number of days spent as inpatient and the choice/location of hospital. You could expect to incur expenses of roughly $8000-9000 for one-night stay in hospital and $1000/day afterwards. You must also be aware that if there are any surgical or other complications during the admission, these would not be covered by any insurance providers, and the expected costs could dramatically escalate. We are happy to discuss your options if you do not have private insurance.
Access to superannuation
It is possible to access your superannuation to help pay for your weight loss surgery. This requires applying to The Department of Human Services for early release of their superannuation funds. You can find details of this on the Department of Human Services website.
Refunds from the Australian Taxation Office
It is possible to claim a rebate form the ATO when you submit your end of year tax return. Weight loss procedures qualify for the medical expenses safety net. If the net total of all of your medical expenses for the financial year exceed $2120, you can claim a tax offset of 20% of your net medical expenses over $2120. This is not means tested and there is no limit on the amount you can claim.
For example:
If your total out of pocket expense is $5000: You may get a tax rebate of $576
($5000-$2120) X 20% = $576 you can claim back as a rebate.
Check with your accountant if this applies to you.