05/08/2025
📣 Important information for patients considering Oral & Maxillofacial Surgery
As highlighted by Townsville Oral & Maxillofacial Surgery, most Oral & Maxillofacial Surgical (OMFS) Services fall under the category of “Plastic & Reconstructive Surgery” in the Medicare Benefits Schedule (MBS). Whilst the two specialties differ significantly in the services they offer, the MBS does not separate the two categories. Similarly, some OMFS services fall under Orthopaedic Surgery.
What this means for you...
If you choose to exclude Plastic & Reconstructive Surgery from your hospital policy and you need Oral & Maxillofacial Surgery (medical services that attract a Medicare rebate whilst in hospital), you may be deemed “not eligible” for your admission ie. you will be classed as UNINSURED.
Please consider this when taking out Hospital Cover with any Private Health Fund.
Members are choosing basic or lower tier levels of cover and excluding “Plastic & Reconstructive” cover, (as they think, for example: “I won’t be needing/having cosmetic surgery, breast augmentation etc”), to avoid the higher premiums.
Unfortunately, most of our frequently performed OMFS Services (like Jaw Surgery, Bone Grafts, TMJ Arthrocentesis, Removal of Cysts/Tumor in the Oral Cavity) fall under Plastic & Reconstructive Surgery, and patients are finding out, often via a surprise 😦 phone call from the hospital, that they are NOT covered for their upcoming admission. This can cause significant financial and emotional distress for some patients.
We encourage all patients to read 🤓 your Informed Financial Consent and contact your Private Health Fund well before your admission day, to ensure you are eligible and covered within your policy.
Thank you to Townsville Oral & Maxillofacial Surgery for raising awareness.