Costs of weight loss surgery
The initial consultation to see Dr Free is $175. You will be able to claim back $72.75 from medicare if you have a referral. When we make an appointment for you following the operation there is no charge.
Hospital expenses for gastric sleeve surgery
Private patients undergoing any operation in a private hospital do not have to pay any hospital expenses, as these are covered by their health fund. Some health funds will charge an excess which could be from $0 to $500 depending on your fund and level of cover. Often a 12 month waiting period will apply before you can use your health insurance. You will need to check with your health fund for details.
When you contact you private health insurance company, it’s good to know which item numbers to quote. These can be searched at www.mbsonline.gov.au
The common item numbers we use are:
- Gastric Bypass surgery 31572
- Modified Duodenal Switch (SIPS) 31581
- Sleeve Gastrectomy 31575
- Laparoscopic Adjustable Gastric band 31569
- Reversal of weight loss procedure 31584
You will be charged a single expense for the surgery. This fee covers:
- Surgeon’s fee for the procedure
- Assistant’s fee
- Follow up appointments
- In hospital care
The surgical assistant’s in our team are consultant general surgeons who are undergoing specific training become specialist weight loss surgeons.
The out of pocket costs for the common weight loss procedures are:
- Laparoscopic Gastric bypass $4100
- Laparoscopic Sleeve gastrectomy $3500
- Laparoscopic Gastric Band $2900
- Laparoscopic SIPS $4700
If any additional consultations or operations are required from problems that may arise from the procedure, there will be no further charge.
These will vary according to the type of operation, the length, and any medical co-morbidities you have. We have a close working relationship with a group of anaesthetists experienced in the specific medical problems of obesity. Your anaesthetist will contact you prior to the operation and you can discuss specifics of payments then. Often the charges will be of the range $600-$1300. As stated above, these fees are partially rebatable.
You will be required to commence a low calorie meal replacement diet (Optifast) for 2 weeks prior to the operation. You will need to pay for these meal replacements. They are generally available at a pharmacy and for a 2 week course cost about $150.
If we arrange for you to see any other specialists prior to your surgery, such as endocrinologists, cardiologists, or respiratory physicians they may charge you for these visits.
There may be additional costs such as blood tests or x-rays required before or during your stay, depending on your health fund.
Reasons for GAP payments
Unfortunately the full costs involved in providing quality medical care are not adequately covered by medicare. Most common surgical procedures performed by experienced surgeons in the private health system involve a gap payment. Weigthloss surgery has even more costs, as multiple professionals are involved in your care, and care by your surgeon needs to be lifelong.
The following graph shows how medical expenses compared to medicare rebates offered by the government.
Not Privately insured
If you do not have any private insurance the expenses of weight loss surgery are very great. The expenses would depend on the specific procedure, equipment used, the cost of the prosthesis, theatre fees, Surgeon’s fee, Assistant surgeon’s fee, Anaesthetist’s fee, Intensive care fees if this is required, and the number of days spent in hospital. You could expect to incur expenses of roughly $15,000 for a two night stay in the hiospital. You must also be aware that if there are any surgical or other complications during the admission, these would not be covered by any insurance providers, and the expected costs could dramatically escalate. We are happy to discuss your options if you do not have private insurance.
Access to superannuation
It is possible to access your superannuation to help pay for your weight loss surgery. This requires applying to The Department of Human Services for early release of their superannuation funds. You can find details of this on the Department of Human Services website.
Refunds from the Australian Taxation Office
It is possible to claim a rebate form the ATO (Australian Taxation Office) when you submit your end of year tax return. Weight loss procedures qualifiy for the medical expenses safety net. If the net total of all of your medical expenses for the financial year exceed $2120, you can claim a tax offset of 20% of your net medical expenses over $2120. This is not means tested and there is no limit on the amount you can claim.
If your total out of pocket expense is $5000:You may get a tax rebate of $576
($5000-$2120) X 20% = $576 you can claim back as a rebate.
Check with your accountant if this applies to you.
For further details see the Australian Taxation Office website by clicking here