Costs and financial assistance for breast reconstruction

Before you have surgery, find out how much it will cost to have a breast reconstruction.

Check with your surgeon, the hospital, Medicare and your private health fund, if you have one, before deciding to go ahead. Find out whether you may need to pay for extras such as pain medicines, post-surgical bras and check-ups with your surgeon.


How to get financial assistance

Ask the hospital social worker what services are available — There are many services available for help with other costs associated with a reconstruction, such as transport costs to medical appointments and prescription medicines. Ask the hospital social worker which services are available in your local area and if you are eligible to receive them.

Talk to a qualified professional about your situation — Professionals may be able to offer legal or financial advice. Cancer Council offers free legal and financial services in some states and territories for people who can’t afford to pay – call 13 11 20 to ask if you are eligible.

Check if you’re eligible for Medicare assistance — If you have your nipple tattooed, it is covered by Medicare if a doctor does the tattooing. If a professional tattooist does the work, it is not covered and you will have to pay yourself.

      — Gwen

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What to consider – reconstruction costs

Public hospital

  • Reconstruction after a mastectomy is a medical procedure, not a cosmetic one, so the costs are covered through Medicare for a public patient in a public hospital.
  • There may be some extra charges if an implant is used.
  • There may be some charges for private patients in a public hospital.
  • If you choose to have a delayed reconstruction, you will be put on the hospital’s elective surgery waiting list. You may need to wait many months for the operation. Ask your surgeon about the likely waiting period.
  • You can put your name on a waiting list even if you’re not sure that you want a reconstruction.

Private hospital

  • Private patients must have private health cover or pay the extra costs.
  • In a private hospital, Medicare will cover some of the surgeon’s and anaesthetist’s fees. Your health fund will cover some or all of the remaining costs, but you may need to pay a gap fee or a hospital admission fee.
  • Part or the entire cost of an inflatable tissue expander and any permanent implant may also be covered by your insurance provider.
  • If you decide to join a health fund before your operation, you will have to wait the qualifying period before you can make a claim. This may be up to 12 months. Check with the different health funds.

This information was last reviewed in June 2017
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