Costs If You Have Private Health Insurance

If you have appropriate private health insurance, you could be covered for gastric banding surgery. There will usually be a “gap”. This is the amount that is not covered by your fund, and is your out-of-pocket cost. The out-of-pocket expense for those with private health insurance is typically between $3000 and $5000.

Generally your clinic fee will cover all aspects related to your gastric banding surgery, as well as all associated aftercare and support.

Check with your clinic if your costs include:

• Surgeon, anaesthetist, assistant surgeon
• Band check-ups (these are usually done monthly until you reach your goal weight, and then usually once to twice a year)
• Band adjustments
• Support such as:
  • Psychologist consultations
  • Dietitian and nutritionist consultations

Check your private health insurance to ensure you are covered

Most levels of private health insurance cover weight-loss surgery, but some of the more basic levels of cover may not. There may also be a waiting period, especially if you have recently joined a health fund.

To check your coverage with your insurer, you can give them the Medicare gastric banding item number 30511. Some of the major private health insurers you can contact are:

• AHM: (+61) 134 246 www.ahm.com.au
• Medibank Private: 132 331 www.medibank.com.au
• NIB: 131 463 www.nib.com.au
• Australian Unity: 13 29 39 www.australianunity.com.au
• HCF: 131 334 www.hcf.com.au
• MBF: 131 337 www.mbf.com.au
• HIF: 1300 30 40 60 www.hif.com.au
• HBF: 133 423 www.hbf.com.au

For a more detailed and comprehensive explanation of the estimated out-of-pockets, contact your local clinic, as they can differ from clinic to clinic.

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