Private Health Insurance – exclusions and restrictions
Many members of the public are unaware that the term plastic surgery encompasses both reconstructive and cosmetic plastic surgery.
“Reconstructive plastic surgery” is usually an operation, treatment or procedure performed on an abnormal structure, deformity or tissue of the body arising as a consequence of congenital defects, developmental or acquired abnormalities, trauma, disease, tumour, including surgery or other treatments for such conditions or defects. The definition also includes gender reassignment surgery.
“Cosmetic plastic surgery” is an operation, treatment or procedure undertaken to improve appearance where no prior injury from trauma, disease, congenital disorder, congenital or acquired deformity exists.
Some private health insurance policies exclude all plastic surgery procedures. Some examples of medically necessary reconstructive plastic surgery procedures include, but are not limited to:
Consumers should check their health insurance policy to ensure adequate cover for Plastic and Reconstructive Surgery Procedures.