Rhinoplasty is
one of the most popular plastic and cosmetic surgery procedures. Despite the popularity, a lot of patients are confused about whether there is Medicare for nose surgery or not. Unfortunately, there isn’t a straightforward yes or no answer to the question. That is why we have compiled all the information in this article that can help you determine whether you are eligible for funding from Australian Medicare or not. Eligible patients may get their Medicare rebate through Nose Surgery item numbers
41671, 41672, 45635,
45641, and 45644. Dr Scott Turner is an experienced Plastic Surgeon and Sydney
Nose expert who has developed his own unique surgical techniques – find out more about his Nose Surgery and you can see more photos of his rhinoplasty before and after past patient results during a consultation. It is important to understand that Rhinoplasty will not be covered by Medicare if you are getting it done for purely aesthetic reasons. However, if the surgery is deemed as a medical necessity, you may be eligible for Medicare coverage. Generally, people who have one of the following conditions may get a medicare rebate: A Nose Job or nose
reshaping is a popular surgical procedure that can give you a better-shaped nose and improved breathing. There are different types of nose procedures that can be performed to enhance the aesthetic appearance, but also to allow you to breathe better. Rhinoplasty can be a truly life-changing procedure. The surgery will quieten the insecure voice in your head, give you a better-looking nose and can improve your quality of life. Moreover, you will be able to breathe easily and comfortably post-surgery which can be truly life-altering. With the new nose and
improved sense of breathing, you can have a new outlook on life and will also be able to pursue a wide range of physical activities (without worrying about breathing) and sleep more comfortably. The confidence you get post-surgery is a plus in itself and can benefit you in every walk of life. In order to claim your Rhinoplasty on Medicare, you will need a Medical Referral from your General Practitioner or Specialist. You can get it prior to booking an initial consultation with your surgeon or after the first appointment. It is important to demonstrate
medical necessity in the referral, including breathing troubles and other issues. While consulting with your GP, it is worth discussing your symptoms to ensure the clinical need is documented in your referral. The answer to this is ‘MAYBE’ – Medicare offers rebates on
Rhinoplasty procedures if you meet the special criteria and conditions as listed below. How Do You Qualify for Medicare Rebate for Rhinoplasty Surgery? – MBS Item NumbersThe most relevant MBS item numbers for Nose Surgery are:
Will Medicare Cover Nose Surgery for Medical Reasons? – MBS CriteriaIf you have the required documentation for Rhinoplasty Surgery and you meet the Medicare criteria, you can qualify for a rebate. It is important to note that the recent MBS changes included additional photographic proof, examination evidence, reporting documentation, and stricter patient criteria for Medicare rebates. Your eligibility will essentially be based on the following Medicare criteria; 41671 – NASAL SEPTUM, SEPTOPLASTY, SUBMUCOUS RESECTION or closure of the septal perforation. Benefits are payable for septoplasty (item 41671) when performed in conjunction with rhinoplasty. Full clinical details must be documented in inpatient notes, including pre-operative photographic and/or NOSE Scale evidence demonstrating the clinical need for the service as this may be subject to audit. 41672 – Reconstruction of the nasal septum 45635 – Rhinoplasty, partial, involving correction of bony vault only, if: The indication for surgery is:
45641 – Rhinoplasty, total, including the correction of all bony and cartilaginous elements of the external nose, with or without autogenous cartilage or bone graft from a local site (nasal), if: The indication for surgery is:
45644 – Rhinoplasty, total, including the correction of all bony and cartilaginous elements of the external nose involving autogenous bone or cartilage graft obtained from a distant donor site, including obtaining of graft, if: The indication for surgery is:
Will Health Insurance Help Cover the Cost of the Rhinoplasty Surgery?You need to meet strict criteria for your insurance or Medicare to pay for the surgery. It is important to be fully aware of Medicare codes and rebate eligibility criteria as these two factors can change & affect your claim. If you qualify for Medicare you may also be eligible for rebates on the Rhinoplasty surgery from your Private Health Insurance Provider. This only applies if your condition meets the criteria for Medicare Item Number and you have the right level of coverage. It is important to check directly with your own Private Health Fund, regarding your policy as they can differ. Please quote the item numbers. Be careful when they tell you that you are “fully funded” – this just means they will pay a subsidy towards your surgery. Why is Medicare for Nose Surgery Rhinoplasty Confusing for a Lot of Patients?We all are born with different noses. If we take into account the complex structure of nasal airways, you can see that Rhinoplasty is a highly customized procedure. Different patients deal with different kinds and types of nasal obstructions. While applying for rebates, subsidies and financing, it gets quite difficult to measure the extent of these nose issues. That is the prime reason why Medicare and private health insurance providers are very strict in terms of their assessment and are required to meet the defined criteria in order to get the rebate. If you manage to prove the medical justification and need for the Rhinoplasty, you are more likely to get a rebate and subsidy. NOTE – Medicare Rebates are Subject to Change and ReviewPlease note that MBS Item codes are reviewed regularly and can be changed/eliminated from the Medicare rebate schedule at any time. If you are currently eligible for a Medicare rebate for Rhinoplasty, it is best to get the procedure sooner rather than later. Will My Private Health Fund Cover My Rhinoplasty?Private Health Funds only cover a procedure if;
Top Tips for Dealing with Medicare Regarding Your Nose Surgery Rhinoplasty Claim
How Much Will My Rhinoplasty Cost if Self-Funded?The cost of getting a Rhinoplasty in Sydney by a specialist plastic surgeon can vary significantly depending on the experience and expertise of the surgeon, area, and the hospital. Visit the surgery pricing page for more information. Typically, a nose job (rhinoplasty) will cost between $8,000 and $20,000 AUD. The variation in cost can also be attributed to the highly customised nature of the procedure. You can contact Dr Turner’s team for an estimate or come for a consultation to get a quote. We will also help you understand the costs and risks associated with the surgery. Our team can also help you access your eligibility for coverage by MBS or your health fund. In addition to that, you can also speak with our patient care team on 1300 641 199 to get any help you might need. Funding Your Nose SurgeryCan I Use My Super Fund to Pay for Rhinoplasty Surgery?Some patients use their own super fund to pay for their rhinoplasty. Before requesting the early release of funds, it is very important to note that:
Can I have a Nose Surgery Payment Plan?Medical Finance companies may be able to help you fund your nose surgery. Please visit the Finance and payment plan page for more information. You can also prepay your surgery over time as a pre-payment plan. FAQs on Medicare for Nose SurgeryHere is a list of frequently asked questions we get regarding Medicare coverage for rhinoplasty: How do you get a nose job with Medicare?
Can a nose job be covered by Medicare?
What qualifies you as a good candidate for a nose job?Here is a basic outline that will help you qualify for the nose job:
Does Medicare cover Nose surgery – rhinoplasty for a deviated septum?
Do you get a free nose job if you have a deviated septum?
When is a Rhinoplasty medically necessary?
Why is cosmetic surgery NOT covered by insurance?
For more information
About Dr Scott Turner FRACS (Plas) – Specialist Plastic SurgeonDr Scott J Turner has spent a lifetime acquiring the qualifications, education, training, and hands-on surgical experience to perform superior cosmetic plastic surgery to give you natural, beautiful results and the improved sense of well-being you want. He is one of the top Specialist Plastic Surgeons with a Breast and Body Surgery focus in New South Wales. Achieving this personal goal requires not only in-depth knowledge of human anatomy and refined surgical techniques but an ongoing commitment to learning the latest procedures around the world. This is why Dr Turner regularly attends both local and international surgeon meetings – discussing these advances with the leaders around the world in order to offer you the most natural, effective and safest surgical procedures. He is a committed board member of ASAPS – Australia Society of Aesthetic Plastic Surgeons Dr Turner and his highly trained staff will do everything to ensure that you are fully informed, while providing exceptional, world-class cosmetic plastic surgery, in a personal and caring environment. Next StepsAlways Do Your Research
Do you need a Medical Referral to see Dr Turner?
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Contact us or call on 1300 641 199 to arrange your surgeon consultation in Sydney or Newcastle. Email us for more information: [email protected] Can you claim cosmetic surgery on Medicare?Medicare will not cover 'non-therapeutic cosmetic surgery, in other words, Medicare will not cover elective surgeries that you choose to pursue purely for cosmetic reasons – it will only cover procedures that are clinically necessary for your health or medically necessary that meet strict criteria.
Can I get septoplasty with Medicare?Medicare Item Numbers Used for a Nose Job
Benefits are payable for correcting a deviated septum (Septoplasty – MBS Item 41671) where performed in conjunction with Rhinoplasty. Item 45638 applies where surgery is indicated for the correction of nasal obstruction, post-traumatic deformity or both.
How much is a nose job in Australia?Typically in Australia, a nose job (rhinoplasty) will cost between $8,000 and $20,000 AUD. This is broken up into the following parts: Surgeon's fees – Range between $5,000 AUD and $15,000 AUD, depending on the exact procedure.
How much does a nose job cost?On average, you can expect to pay somewhere around $8,400-$9,800 for a nose job from an experienced facial surgeon. The fee for revision surgery can range from $7,000-$12,000 or even more depending on the complexity of the situation.
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