Does Insurance Extend Coverage to Post-Pregnancy Body Contouring Surgery?

By February 12, 2024News

We have some great news for those seeking post-pregnancy body contouring surgery.

In 2022, Medicare reinstated coverage for specific procedures, recognising the challenges women face after childbirth.

At Southern Aesthetic, we proudly support the women who are in need of repairing their muscle and skin damage that was caused after pregnancy.

Abdominoplasty and Private Health Insurance:

One of the most significant hurdles for patients considering abdominoplasty, commonly known as a tummy tuck, was the uncertainty surrounding insurance coverage. The good news is that Medicare, after temporarily withdrawing the item number, has reinstated it.

This renewed coverage acknowledges the physical toll childbirth takes on a woman’s body, with abdominoplasty providing relief for many post-pregnancy concerns.

The benefit of this development lies in the fact that private health insurance can now be utilised for the hospital and theatre stay associated with the surgery. This means that eligible patients can benefit from coverage for approximately 50% of the overall cost, making post-pregnancy body contouring more accessible and affordable.

Breast Surgery and Medicare Guidelines:

While the excitement over abdominoplasty coverage is clear, it’s essential to clarify the guidelines for breast surgery following the effects of breast ptosis, commonly known as sagging or drooping breasts. Medicare coverage for breast surgery is contingent on specific criteria to ensure it is used for medically necessary reasons, rather than purely for aesthetic improvements.

For breast surgery to be eligible for Medicare coverage, the nipples must be pointing downward, and a significant amount of breast gland tissue must hang below the inframammary fold—the natural crease line of the breast. These criteria emphasise the need for medical conditions causing functional problems rather than focusing solely on aesthetic concerns.

The Role of Medicare in Medical Conditions:

The reinstatement of coverage for post-pregnancy body contouring surgeries aligns with Medicare’s mission to support individuals facing medical conditions that impact their well-being and functionality. This acknowledges the physical and emotional challenges women may experience after childbirth.

While celebrating this positive development, it’s essential to understand and adhere to the guidelines set by Medicare, especially when considering breast surgery. The focus should be on addressing medical conditions that cause functional problems, emphasising the medical necessity of these procedures over purely aesthetic motivations.

Post Pregnancy Body Contouring Sydney Surgery at Southern Aesthetic Plastic Surgery

With surgical expertise and insurance support, Southern Aesthetic offers a comprehensive approach to post-pregnancy body contouring, not only focusing on physical improvements but also prioritising the emotional well-being of their patients.

Serving as a trusted partner in this journey, we embody the evolving landscape of healthcare, where holistic care encompasses both medical necessity and aesthetic considerations

Leave a Reply