Hi, this is Dr. Bernard Beldholm,
and I'm a body contouring surgeon.
I help men with gynaecomastia,
and also do a lot of other body contouring work.
But I've been doing gynaecomastia, for the last, what,
12 years, something like that.
And I see a lot of men with gynaecomastia.
So the question is, is gynaecomastia covered by Medicare?
There, so, is gynecomastia covered by Medicare?
That's a very common question.
Now, first of all, the gynaecomastia operation
is not done in the public system.
So you have to have it done in the private system.
The private system means that you need to either pay
for the hospital stay and the surgeon's fees,
and if you want some of that to be covered,
you need to have health insurance.
Now, there is what's called
an MBS item number for gynaecomastia.
And that is, let me have a look at it,
it's 31525, so that, MBS item number is 31525,
and it's breast subcutaneous mastectomy for gynaecomastia.
It needs to be done in a hospital,
so in a private, accredited facility,
which means that a lot of surgeons that do it in their rooms,
so they just do sculpture [...]
and are not proper surgeons
and don't do it in a private hospital,
can't claim that item number.
So if you have private health insurance,
usually, you have to check with the private health insurance
[to see] if they cover that item number.
A lot of time, there are exclusions.
You have to have top cover,
you have to have it for 12 months.
So there are a lot of admin-type things
that you need to check into.
But if you are covered, there is an MBS item number.
And what does that mean?
Well, it means that you will get the hospital covered.
You may have some out-of-pocket charges.
Sorry, you may have access by your health fund,
but all the costs of the hospital, your hospital stay,
if you stay in for a few nights [are covered].
And one important thing is that if you have a bleed,
or if you have a complication from your surgery,
we can take you back to the operating theater
and the health fund will cover all of that,
rather than you having to pay out of pocket for it.
So having a health fund
and being covered is really important.
Now, the health fund says that you're not supposed
to do it for cosmetic reasons.
So you need to have a significantly large gland.
You need to have, maybe, pain, discomfort
from the gland as well.
So that's something to keep in mind.
Now, you will get some money back for the anaesthetic
charges and also the surgical charges.
The amount you get back will [vary]
from health fund to health fund.
And you get that money back once you've had the surgery.
So you do have to pay us the fees first,
You get a receipt once you've had your surgery,
and then you can claim back from your health fund
the cost, a portion of the cost.
So I hope that helped.
We're always here to help, so you can send us a message.
When you come in to me,
you'll see my patient coordinator
that will explain all that to you,
and you will get all your quotes and times,
et cetera, as well. So I hope you found this helpful.
This has been Dr. Bernard Beldholm,
and I love helping guys with gynaecomastia
get their body back and get a flat chest,
so come and see me.