Plastic and reconstructive surgery (medically necessary)

What are 'Plastic and reconstructive surgery (medically necessary) services'?

Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity, whether acquired as a result of illness or accident or congenital. For example: burns requiring a graft, cleft palate, club foot and angioma.Plastic surgery that is not considered medically necessary (cosmetic surgery) cannot be paid on any Private Hospital Insurance policy.

  • Plastic surgery that is medically necessary relating to the treatment of a skin-related condition is listed separately under Skin.
  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Which level of Hospital cover includes these services?

To find out which level of Hospital cover includes Plastic and reconstructive surgery(medically necessary), please refer to our Hospital Comparison Table.

Which level of Hospital cover includes these services?

Please refer to privatehealth.gov.au for MBS item numbers that are included in the 'Plastic and reconstructive surgery (medically necessary)' services category

Important, please note.
The MBS item numbers listed will attract benefits from HIF provided that:

(a) the MBS item number forms part of a hospital inpatient admission;

(b) the Member holds an eligible Hospital Cover product which includes the clinical category that the MBS item relates to;

(c) the Member has served the necessary waiting periods; and

(d) the Membership is financial at the date of service.

To search for more information on a  particular MBS item number, simply copy and paste the MBS item number into the Private Health website which will advise the clinical category of the MBS item number.