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Removal of Breast Implants. New Rules for Medicare Rebates

Wednesday, October 31, 2018

Medicare has advised that from the 1/11/2018 new rules will apply to the procedure of removal and replacement of breast implants.

Medicare will continue to allow use of an Item Number for removal of breast implants but not when performed in association with the insertion of new breast implants.

This means that if you would like your implants removed and replaced with new implants then no Medicare rebate will apply, that there will be no Hospital Benefit payable by your Health Insurance Fund and that GST will be applicable to all costs.

If you have your implants removed as an independent procedure then a Medical Item Number is applicable, your Private Health Insurance Fund will cover your hospital costs and no GST is applicable.

 

In instances where you have your breast implants removed and other procedures are performed (e.g fat transfer to the breasts or a breast lift) then you can still use the Medicare Item Number to claim a rebate for the removal and your Health Fund will pay a part benefit for the hospital costs. GST will only be applicable to the non-Medicare item number portion of your surgery.

Medicare has taken the view that it is no longer appropriate to encourage (by subsidising) the insertion of breast implants as these will require further surgery in the future.

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