The answer to this question is : depends. You will need to meet certain conditions which have changed since 1 January 2016, in order to claim Medicare Item 30177. Typically, the patients who will be eligible have had massive weight loss (shown by a drop in BMI) with dermatological skin conditions due to having excess skin and tissue. Dr Milovic carefully assesses his patients, during an in person consultation, about whether this item number applies.
Who can assess Medicare Item numbers for plastic surgery procedures?
Only Specialist Plastic Surgeons, like Dr Milovic, are recognised by Medicare Australia to determine a patient’s eligibility for plastic surgery procedures, such as abdominoplasty or tummy tuck procedure. This means that Cosmetic Surgeons, who don’t have formally recognised surgical qualifications cannot assess Medicare item numbers for patients. Cosmetic Surgeons don’t have a FRACS (Plast) after their name. The FRACS means Fellow of the Royal Australasian College of Surgeons, the only body who is formally recognised by the Australian government to provide surgical training in Australia.
You should do your homework to check your surgeon’s qualifications before having surgery. If a surgeon is vague about their qualifications, it is highly unlikely that they are a Plastic Surgeon, and you need to do further research about them.
A Plastic Surgeon should only perform tummy tuck procedures in an accredited hospital or facility, for your safety and to ensure that you can claim item 30177 if eligible.
Not all tummy tucks are cosmetic procedures
Not all tummy tuck procedures are for cosmetic reasons. Medicare Australia recognises that there can be medical or functional reasons for a tummy tuck procedure which include back pain, abdominal wall repair or MAS (musculoaponeurotic repair), and excess skin after massive weight loss.
To claim item 30177, you must have a GP or specialist referral to the plastic surgeon of your choice. If you want to see another plastic surgeon, make sure that your referral is updated to reflect the name of the other surgeon.
If you have private health insurance, and you meet the conditions for item 30177, you should check with your fund before having the procedure to ensure that you have cover for this item number, as not all health fund policies cover plastic surgery items. If you don’t have the relevant cover, you will need to pay the hospital accommodation as an out of pocket expense.
Regardless of whether there is a Medicare item number or not available to you, please remember, abdominoplasty surgery, or any surgery for that matter, must be carefully considered and you need to feel informed about your post operative risks and complications, as well as being financially and emotionally ready should they occur.
If you have any further questions about the tummy tuck procedure, please do not hesitate to contact Dr Milovic via the form below, or call our clinics in Melbourne (03 9819 3786) or Canberra (02 6260 4882).
Contact Dr Milovic
Please complete the contact form below with your enquiry, and we will answer you as soon as possible.