Posted by Shantael Loomes, Patient Care Co oridinator on 18 June 2019

Shantael talks to us about Breast Reduction Surgery What does it really cost to have a Breast Reduction?

A large part of my position as Patient Care Coordinator / Practice Manager at Sandhurst Plastic Surgery is to provide patient quotes, discuss possible Medicare and Health Fund rebates and help patients to be informed of the financial aspects of surgery.

I always find whenever discussing a quote for Breast Reduction Surgery that i get the same reaction from most patients - “If i had known it was that price i would have had it done years ago!”

While everyones' budgets, disposable income and outlook on what constitutes an affordable surgery may differ, it surprises me that so many women are under the assumption that Breast Reduction surgery is a extremely expensive venture.

I really struggle to put my finger on where exactly this information is coming from to give women this assumption. Is it the media, our friends, or is it just the perspective that Plastic Surgery is for the rich and famous and unaffordable for the “average Jo / Joanne”?

It greatly saddens me that women may be missing out on getting medically-necessary surgery that could offer them fantastic health and quality of life benefits - simply because of public perception on pricing stopping them from even enquiring.

Again, public perception seems to be that any form of breast surgery is classed as Cosmetic, but that just isn't the case. We are very fortunate in Australia that the Department of Health understand the health implications of heavy breasts and the health and functional burden this can have on women, and allow for this procedure in most cases to be claimable under the Medicare Benefits Scheme.

"Ok so how much does it actually cost then?"

Pricing for Breast Reduction surgery differs on a number of factors:

1 Are you a public patient?

2 Do you want to self fund?

3 Do you have private health insurance?

Public Patients

Breast Reduction procedures can be done through the public health system, the benefit of this is that there are no out of pocket expenses and all associated costs are completely covered by Medicare, 

Sounds to good to be true? Well, yes and no.

While you will be fully covered through the public system there are often very long wait times associated with being able to get a Breast Reduction done through a public hospital.

The reason for this is that while it is a medically required procedure, it in not considered an urgent or life saving procedure. Due to the sheer abundance of patients that come through public hospitals this type of procedure often gets put on the back burner of the “Wait List” to allow for the patients requiring more urgent surgery to have their procedure done.

While this seems a small price to pay to have a “free” surgery, it is often an extremely frustrating situation to be in.

I have spoken to patients that have been on wait lists for 3+ years and still have not received any confirmation of a surgery date.  The reality is that although breast reduction surgery can be done in public hospitals, the practicality is that it may not happen.

Due to this factor I talk to a large amount of public patients that decide to self fund to eliminate being subject to large wait times and the subsequent deteriorating health implications of this wait period.

Obviously the choice to self-fund is a completely personal decision to make.

Self Funding Patients:

Self funding patients are patients who do not have private health insurance, but wish to pay the fees to go through a private hospital themselves.

When self funding there are 3 sets of fees to be considered, Surgeon fees, Hospital fees (including overnight bed fees) and Anaesthetic fees. All these fees are billed separately by the appropriate parties.

These fees will all differ given the duration and complexity of your particular surgery, surgery is not a “one size fits all” and is tailored to each individual patients requirements.

As a generalised indication of these prices you could be looking a combined estimated total of around $11,000 - $12,00 upfront with a about $1,300 being available back from Medicare after the surgery for Surgery organised through Sandhurst Plastic Surgery

*please note fees differ depending on surgery duration and complexity, as such the fees depicted here may not be accurate to what your procedure may be quoted. This information is provided for guidance only and is not a set fee for this procedure.

While $11-12k would not considered “pocket money” is certainly isn't the $20,000+ that people assume the surgery to cost when self-funding.

Patients with Private Insurance:

Patients with adequate private health insurance find themselves in the best financial position for this surgery.

This is because with a decent policy your insurer will cover the costs associated from the Hospital and Anaesthetist and offer you a further rebate on the surgeon fees.

Surgeon Fees: $6,500.00

Estimated Rebate: $1,350

Out of Pocket Cost: $5,150

Hospital Fees: Excess amount set up with your insurer (if applicable)

Anaesthetic fees: Out of pocket gap of usually around $500

Combined Estimated Total: $7,000 + excess upfront / $5,650 + excess after rebates. Both of these fees are for surgery performed by a highly trained Specialist Plastic and Reconstructive Surgeon, Specialist Anaesthetist at a fully Accredited Hospital.

Contrary to popular belief, you do not need prior approval to claim this procedure under your insurance, or a top level hospital cover, as long as you have a bronze or approve policy that covers you for the applicable item number (45523) you will be able to claim this under insurance,

This is not cosmetic surgery and as such if you have a valid policy your insurer can not refuse to cover your procedure.

So there you have it ladies, the real costs associated with having a Breast Reduction procedure at Sandhurst Plastic Surgery. While these are just examples and pricing will differ from patient to patient i think it is so important to get this basis of information out there. This is to assist anyone who is sitting at home, wanting surgery, possibly starting to research surgery, chatting to their GP about surgery - but putting it off due to the idea of the costs involved - to have the correct information available to them to help make an informed decision.

I am passionate about patient education and I think the hardest thing when it comes to Plastic Surgery is finding the right information online.

If you have any questions relating to this blog please don't hesitate to reach out and contact me.

 

 

Shantael Loomes

Patient Care Co-ordinator

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