In the next few months there are big changes coming for Medicare rebates and health fund coverage for plastic surgery procedures. This article will help you understand if your plans are impacted.

Medicare changes on 1 November 2018

We were advised this week that Medicare will change many item numbers from 1 November 2018. Some are being abolished, while others are becoming much stricter in terms of eligibility. This is because the government believes that Medicare item numbers are currently being used by patients who have ‘cosmetic’ rather than functional needs. We have seen the draft of the new Medicare schedule which bring changes for:

  • Eyelid Surgery
  • Rhinoplasty Surgery (Nose Surgery)
  • Prominent Ear Surgery (Otoplasty)

New health fund tiers

You may also have seen media that health funds will be changing to a new standardised tiering model from 1 January 2019. This will likely impact the coverage that your fund may have for certain Medicare item numbers.

What does this mean for you?

Quotes we have issued which feature an item number and therefore attract a Medicare rebate and fund rebates (for insured patients) are only valid for surgery up to 31 October 2018.

After that date, we will have to provide new quotes based on the final version of the new Medicare item numbers which may mean you are not covered.

 Should I book surgery before 31 October?

Only if it is the right time for you! While a Medicare rebate and fund coverage is a bonus, the timing still has to be right for you and your family.

What next?

Please contact us if you want to discuss the implications of these changes for your surgical plans by our rooms on (02) 9387 3900 or emailing reception on