Is Medicare withdrawing their abdominoplasty rebate?
There are current speculations that Medicare will shortly introduce changes to their item numbers related to abdominoplasty (tummy tucks).
Medicare covers a certain number of plastic surgery procedures and this has always revolved around whether the procedure is considered reconstructive (medically necessary) as opposed to merely cosmetic. This means that any surgery that is not identified as necessary for medical purposes will not be claimable. While Medicare still offers a rebate for a number of procedures, it is understood that there are plans to remove certain coverage from 1st November 2015. The Department of Health is seeking to make changes regarding the item number 30177, among others. This means that there will no longer be a subsidy for abdominoplasty.
While the proposal is yet to be legislated (it is currently awaiting authorisation by the Federal Ministers for Health and Finance), it is very unlikely that it won’t be passed. The speculation surrounding the proposed changes is gathering momentum as surgeons, practitioners and patients wrap their heads around the possible modifications. Unless a weighty industry protest is organised, the new regulation is anticipated to be approved.
A number of different plastic surgery items are expected to be affected, but a very large number of future patients will suffer from this specific overturning. Tens of thousands of patients go through this procedure in Australia yearly and this figure is only rising.
If you think that these changes will apply to you, we advise you to consult your surgeon who will better be able to identify your situation. You can find the current description and requirements for any item number on the Medicare website – make sure that you have a close look at all the information and contact your surgeon if you have any queries.