Tonsils, Adenoids and Grommets

What is covered under Tonsils, Adenoids and Grommets?

Hospital Cover for Tonsils, Adenoids and Grommets includes hospital treatment to:

• remove tonsils
• remove adenoids
• insert or remove grommets.

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

Some treatments you might expect to be in the Tonsils, Adenoids and Grommets clinical category are under different clinical categories. For example, treatments for throat and sinus problems are under Ear, Nose and Throat.

Which Hospital Cover tiers include Tonsils, Adenoids and Grommets?

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 Tonsils, Adenoids and Grommets 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 Tonsils, Adenoids and Grommets. 

Does Medicare cover Tonsils, Adenoids and Grommets?

Yes. Medicare includes all treatments under the Tonsils, Adenoids and Grommets clinical category.

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

Compare Hospital Cover from every private health insurer in Australia

Use our healthslips.com.au Calculator to find the best Hospital Cover for you.