Breast reduction surgery, also known as reduction mammoplasty, is a procedure that reshapes and re-sizes the breasts to better fit your body. It’s performed on women who want to reduce the size of their breasts, or women who want to change the shape of their breasts.
Breast reduction can increase self-esteem and improve physical comfort by helping you feel more confident about your body. It’s one of the most common cosmetic procedures for women in Australia, according to a 2015 report from Medicare Australia. In this guide, we review the aspects of Breast reduction and lift cost australia, breast reduction surgery cost tasmania, breast reduction medicare australia, and free breast reduction surgery australia.
Breast Reduction And Lift Cost Australia
The cost of breast reduction surgery varies depending on factors such as where you live and your surgeon’s experience level. You can expect to pay between $5,000 and $8,500 per breast for a standard procedure in Australia (or between $10,000 and $15,000 total). This includes the surgeon’s fee, anesthesia fees (if necessary), hospital costs (if applicable), medical supplies like sutures or drains used during surgery, postoperative garments like bandages or bras (if necessary), and any follow-up visits required following surgery such as physical therapy sessions or bra fittings if applicable).
In order to determine if breast reduction is right for you
How Much Does Breast Reduction Surgery Cost?
How much does it cost to have Breast Reduction Surgery in Sydney?
This article, covers the average price range for Sydney Breast Reduction Surgery. It will also discuss what to look for in your Breast Reduction Surgeon and your surgical quote. This blog will only cover the approximate range of breast reduction costs.
Cost of Breast Reduction and Breast Shaping
In Australia there are different surgical techniques or methods used for breast reduction procedures. Further, not all surgeons offer every method, including no-drain options or the Lollipop method favoured by Dr Drielsma. Further the method and surgical approach used will impact your scarring and price range.
A pricing example for the Lollipop (or Le Jour) Breast Reduction procedure would range between $10,000 and $20,000. However this price can vary depending on a wide range of factors. We will discuss the further reasons for price differences below.
Why Do Breast Reduction Costs Vary?
There are a variety of reasons for breast reduction price factors in Sydney. The reason plastic surgery prices differ for breast reduction relates to the following factors:
Who is Performing Your Surgery?
- What is your surgeon’s level of expertise, training and qualifications?
- Does your plastic surgeon have FRACS qualifications and is an experienced surgeon?
- Is your procedure well-planned and customised for natural look shaping and nipple position?
What Does Your Surgeon Include in the Price Estimate or Formal Cost Quote for Breast Reduction
- Is your surgeon using advanced surgical techniques to minimise breast scarring?
- Does your quote include everything or are you going to get hit with unexpected expenses?
- What type of anaesthetic is your surgeon using?
- How will your scars be managed?
When is Your Procedure Being Performed?
Discuss the timing of your surgery with your doctor and patient care coordinator
Hospital fees rapidly change
Medicare rebate criteria also rapidly changes
Insurance policy classifications are also changing in 2019
breast reduction surgery cost tasmania
Many patients get coverage for breast reduction through Medicare in Australia using the popular Medicare item number 45523. The procedure must be seen as a medical necessity by your surgeon and Medicare. It essentially means that you are getting the surgery due to an underlying medical condition. If your surgery is due to purely cosmetic reasons only, Medicare won’t pay for it.
PLEASE NOTE – Dr Turner does not offer FREE Breast Reduction surgery. Medicare and/or your Private Health Insurer may offer a PARTIAL SUBSIDY for a procedure to be done in a private plastic surgery practice like Dr Turner’s. There will still be a SIGNIFICANT GAP PAYMENT for your surgery that you have to pay for. FREE plastic surgery MAY be available in some public hospitals for some procedures but there is a significant waiting period – sometimes many years spent waiting for elective surgery. If you want your surgery sooner than that and can’t afford it – please consider other funding options.
PLEASE NOTE – Dr Turner does not offer FREE Breast Reduction surgery. Medicare and/or your Private Health Insurer may offer a PARTIAL SUBSIDY for a procedure to be done in a private plastic surgery practice like Dr Turner’s. There will still be a SIGNIFICANT GAP PAYMENT for your surgery that you have to pay for.
FREE plastic surgery MAY be available in some public hospitals for some procedures but there is a significant waiting period – sometimes many years spent waiting for elective surgery. If you want your surgery sooner than that and can’t afford it – please consider other funding options.
Dr Scott Turner is an experienced Plastic Surgeon and Breast Reduction expert – find out more about his Breast Reduction Surgery and look at his Breast Reduction before and after results.
Why Should I Consider A Breast Reduction?
Breast reduction is truly a life-altering procedure. The surgery can prevent and treat plenty of recurring problems that come as a side effect to having larger breasts and give you a better quality of life.
Most of the patients feel extremely confident and happy post the surgery. It is almost like they have a new outlook on life and are able to dive into a wide range of physical activities. Moreover, the surgery also improves self-confidence and body image.
With the new confidence and body, you will be able to rock all those clothing options that you previously didn’t. Trust me, it is one of the most fun advantages of getting the surgery.
Research shows that woman’s health improves significantly post-reduction mammoplasty. Neck pain, back pain, shoulder pain, infections and rashes will be completely gone after getting the procedure done.
You’ll need a Medical Referral with Documented concerns
In order to claim your surgery on Medicare, you will need a Medical Referral from your General Practitioner. You can get it prior to booking an initial consultation with a cosmetic surgeon or after the first appointment.
It is important to demonstrate medical necessity, including pain in the neck and/or shoulder region. While consulting with your GP, it is worth discussing your symptoms to ensure the clinical need is documented in your referral.
breast reduction medicare australia
Generally, Medicare needs to consider your procedure medically necessary for it to be covered. This means that your breast reduction needs to be related to a medical condition. If your reduction is cosmetic, meaning it’s only meant to enhance your appearance, Medicare won’t pay.
Continue reading to learn when Medicare will cover breast reduction surgery, rules for eligibility, cost considerations, and more.
Whether or not Medicare will cover breast reduction depends on your reason for having the surgery. There are several common reasons you might want or need a breast reduction, including:
Medicare only pays for breast reduction for the first two reasons. In both of these situations, the breast reduction is considered medically necessary, so Medicare will cover it.
If you’re in the third situation, Medicare would consider your surgery cosmetic and would not cover it. You’d need to pay for 100 percent of the costs out of pocket.
If your self-esteem is being seriously affected by the size or shape of your breasts, talking to a licensed therapist might be helpful. Medicare does cover mental health services under Part B (medical insurance).
You can get counseling appointments covered and work with a professional on the best way to address how your body is affecting your self-esteem.
You’ll qualify to have your breast reduction covered if you meet Medicare’s conditions.
In the case of breast reduction for reconstruction after a mastectomy, Medicare will cover the procedure. Your doctor will just need to provide documentation to Medicare that you’re having breast reduction because of your mastectomy.
If you’re having breast reduction for pain, you’ll need to make sure you meet a few more conditions. Your doctor will need to verify that:
In some cases, your pain might be caused by a specific condition of the breasts called breast hypertrophy (or gigantomastia). Hypertrophy causes the breasts to increase in weight and density, causing pain and other problems.
Medicare will pay for breast reduction in the case of hypertrophy, as long as your doctor states that it is the primary cause of your pain or other symptoms.
You’ll need to get your breast reduction performed at a facility that accepts Medicare to receive full benefits. You can ask your surgeons if they accept Medicare before your first visit. You can also search for providers using the Medicare website.
If you have a Medicare Advantage (Medicare Part C) plan, you might also need to make sure the surgeon and facility you want to use is in network. You can search for surgeons within your plan’s network, contact your plan directly, or ask your surgeon’s office if they accept your plan.
Medicare does not cover any cosmetic surgery procedures. This means that if your procedure is elective and for appearance only, you’ll pay 100 percent of the costs.
This is true no matter what kind of Medicare plan you have. Neither Advantage plans nor Medigap plans offer additional coverage for cosmetic procedures.
The costs you’ll pay for your breast reduction depend on the type of Medicare plan you have and the facility where you have your surgery. You’ll be covered no matter which plan you have, as long as your reduction is medically necessary.
Medicare Advantage plans are required to cover everything that Medicare parts A and B (original Medicare) cover. However, the cost you’ll pay might be different from plan to plan.
Medicare Part A
If you have original Medicare and are admitted as an inpatient for your breast reduction, it will be covered under Medicare Part A.
There are many reasons you may need to be admitted for this procedure, including concerns of possible complications. This may also be the case if you’re having breast reduction at the same time or just after a mastectomy.
When you use Part A, you’ll be responsible for the Part A deductible. The Part A deductible in 2020 is $1,408. You’ll need to pay this amount before your coverage kicks in. You might have already paid into your deductible if you’ve already used other Part A services, such as other hospital stays or home health care visits.
You won’t have any copay costs for days spent in the hospital until you reach your 60th day. Most people don’t need more than a few days in the hospital for a breast reduction. However, you should know that starting on day 61, you’ll pay $352 a day in coinsurance. If you reach 91 days, you’ll pay $704 per day in coinsurance for a total of 60 lifetime reserve days.
Medicare Part B
Your breast reduction will be covered under Medicare Part B if you have an outpatient procedure and are using original Medicare. Outpatient procedures can be done at hospitals or stand-alone surgical centers.
The Part B deductible is $198 in 2020. However, you’re also responsible for 20 percent of the cost of Medicare-approved procedures once you meet your deductible.
So, for example, if the Medicare-approved amount for your breast reconstruction was $6,000, Medicare would pay $4,800 and you’d pay $1,200.
Part B also has a monthly premium. In 2020, the premium is $144.60 for most people.
Medicare Part C
Medicare Part C is also known as Medicare Advantage. Medicare Advantage plans are offered by private companies that contract with Medicare. They offer the same coverage as original Medicare and often include extras such as vision or dental coverage.
Your breast reduction costs under Medicare Advantage will depend on your plan. You’ll generally have copays for procedures or hospital stays. You can call your plan ahead of the procedure to ask about costs, if you’re unsure how much they’ll cover.
Remember that no plan pays for elective cosmetic procedures. You’ll need to pay the full cost in that case. The cost can vary depending on the surgeon you choose, but a 2019 survey found that the average cost for breast reduction surgery in the United States was $5,475.
Your doctor will advise you how to prepare for breast reduction in a way that addresses your specific needs. However, there are some general things you can expect.
free breast reduction surgery australia
The answer to the Medicare rebate question can be daunting and confusing for a lot of people seeking cosmetic surgery. There are many factors that can impact on the answer;
When it comes to Plastic and Cosmetic Surgery, Medicare Rebate guidelines state very clearly that; Medicare will not cover ‘non-therapeutic cosmetic surgery’ or ‘non-therapeutic plastic surgery’ procedures.
However, it also states that significant breast ptosis after pregnancy and chronic Back Pain or Skin Infections related to large breasts are classified as chronic medical conditions and may lead to eligibility for a minor rebate.
Medicare Rebates are subject to unpredictable and sudden changes.
It’s important to remember that Medicare Codes can be removed from the rebate schedule without notice, so if your procedure is currently eligible for a rebate under Medicare you may want to consider having your procedure performed as soon as possible rather than waiting as this may affect your out of pocket cost.
What Plastic Surgery procedures might Medicare cover in relation to eligibility for a rebate?
Unfortunately, this question does not have a straightforward answer as there are many variables. It depends on the patient’s health, well-being and needs. Medicare can sometimes offer partial rebates on:
What Medicare Currently Covers
As stated previously in this blog Medicare will only cover medical and surgical procedures that they deemed clinically NESSASSARY for your health. They will NOT cover elective Plastic Surgery or Cosmetic procedures that you opt to have for purely cosmetic reasons, such as Liposuction on your arms or thighs.
If you are currently suffering from large, heavy breast that is impacting your everyday life you may be eligible to Claim a Medicare item number for your breast reduction surgery, visit your GP and ask for a referral to Dr Rebecca Wyten or phone Coco Ruby Plastic Surgery on 1300 264 811 for more information on Breast Surgery including Reduction Mammoplasty.
Payment Options for Breast Surgery
Medicare Information and Payment Plan Options
If you have begun looking into Medicare rebates and your eligibility, you may be at the financial funding phase of your decision-making process.
To assist you in this phase we have provided an excerpt from our Guide To Funding Surgery. This guide contains helpful information about different ways patients can choose to pay for their cosmetic or plastic surgery procedure/s.
If you have any questions please Phone us on 1300 264 811 and request a copy of our e-book. It contains information on funding for cosmetic surgery including what payment plans are available from external, independent providers and special savings accounts as well as other options for funding your procedure.
We also recommend booking a consultation with a Surgeon as this will give you even more information, as well as the opportunity to get all your questions answered directly