Podiatric Surgery (by a registered podiatric surgeon)

What is covered under Podiatric Surgery?

Hospital Cover for Podiatric Surgery includes hospital treatment for foot and ankle surgery when performed by an accredited Podiatric Surgeon.

Examples include:

• bunions and foot repair
• Achilles tendon repair
• plantar fasciitis surgery
• foot fracture surgery.

Treatments for this clinical category are not covered in the Medicare Benefits Schedule (MBS).

This means your health insurer does not have to pay fees for your podiatric surgeon or anaesthetist. However, it may choose to do so.

Cover is limited to accommodation and the cost of a prosthesis as listed on the prostheses list in the Private Health Insurance (Prostheses) Rules. It does not include theatre fees. 

Note, if you select a Podiatric Surgeon who is not accredited, your private health insurer can pay a benefit under Extras Cover only. You cannot claim under your Hospital Cover.

Before agreeing to podiatric surgery:

• request a detailed treatment quote from your Podiatric Surgeon
• ask for a quote from your anaesthetist
• talk to your hospital about any likely out-of-pocket costs.

Finally, talk to your insurer about exactly what costs it will cover.

Which Hospital Cover tiers include Podiatric Surgery?

What does it mean if cover is ‘optional’?

‘Optional’ means that the Australian Government allows insurers to choose whether or not to cover the clinical category under that Hospital Cover tier.

What does ‘restricted cover’ mean? 

Restricted cover means the insurer pays only limited benefits. 

If insurers offer cover for Podiatric Surgery under Basic Hospital Cover, they can do so on a ‘restricted’ basis. If you are admitted as a private patient in a private hospital for treatments under this clinical category, you will face considerable out-of-pocket costs.

Always check with your insurer before agreeing to be treated as a private patient in a private hospital if you have restricted cover for Podiatric Surgery. 

Does Medicare cover Podiatric Surgery?

No. Medicare does not cover any treatments or devices under the Podiatric Surgery clinical category.

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