Skin Conditions

Reviewed and updated 31 March 2024

basic

bronze

silver

gold

RRestricted

OOptional

Covered

What is covered under Skin Conditions?

Hospital Cover for Skin Conditions includes hospital treatment to:

investigate and treat skin and skin-related conditions
investigate and treat nail and nail-related conditions
remove foreign bodies
perform plastic surgery that is medically necessary and related directly to treating a skin-related condition.

Examples include:

melanoma
ingrown toenails
abscesses
patch testing for dermatitis.

This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS).

Some treatments you might expect to be in the Skin clinical category are under other clinical categories. For example:

removal of excess skin due to weight loss is under Weight Loss Surgery
chemotherapy and radiotherapy for cancer are under Chemotherapy, Radiotherapy and Immunotherapy for cancer.
skin grafts for burns are under Plastic and Reconstructive Surgery (medically necessary).

Which Hospital Cover tiers include Skin Conditions?

Tier	Clinical category covered?	Can insurers offer restricted cover?
Basic	Optional	Yes
Bronze	Optional	No
Silver	Optional	No
Gold	Yes	No

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 Skin 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 Skin.

Does Medicare cover Skin Conditions?

Yes. Medicare includes all treatments under the Skin Conditions clinical category.

If there is an MBS item number for the treatment, Medicare covers it.

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