Weight Loss Surgery

What is covered under Weight Loss Surgery?

Hospital Cover for Weight Loss Surgery includes hospital treatment for surgery to:

• reduce body weight
• remove excess skin due to weight loss 
• reverse a bariatric procedure like a gastric bypass. 

Weight loss surgery is usually performed on people who are morbidly obese. 

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

Which Hospital Cover tiers include Weight Loss 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 Weight Loss 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 Weight Loss Surgery. 

Does Medicare cover Weight Loss Surgery?

Yes. Medicare includes all treatments under the Weight Loss Surgery clinical category.

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

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