Costs, explained
before you commit.

Consultation fees

A consultation fee applies to appointments with your plastic surgeon.

Your consultation is an important part of your care. It allows your surgeon to assess your health, understand your concerns and goals, examine the area being considered for surgery and discuss appropriate treatment options. The consultation also provides an opportunity to discuss:

• whether surgery is appropriate for you
• alternative treatment options
• the expected benefits and limitations of surgery
• potential risks and complications
• recovery and time away from work or normal activities
• likely scars and longer-term outcomes
• whether further investigations or specialist opinions are required
• the anticipated costs of treatment.

Our team will advise you of the applicable consultation fee when you make your appointment.

Where a consultation or treatment attracts a Medicare rebate, our team can provide information about the relevant Medicare arrangements. Eligibility for a Medicare rebate depends on the clinical circumstances and applicable Medicare requirements.

Your surgical quote

Following your consultation and once your surgeon has established an appropriate surgical plan, MIKKO Plastic Surgery can provide you with a written estimate of the surgeon's fees.

The quote is based on the operation proposed at the time of consultation. More complex procedures, combined operations or changes to the proposed treatment plan may affect the final cost.

Your surgical quote will generally identify the professional fees charged by MIKKO Plastic Surgery and, where applicable, relevant Medicare item numbers.

However, the surgeon's fee is only one component of the total cost of an operation. Depending on your procedure, there may be separate charges for:

• your surgeon
• an assistant surgeon
• your anaesthetist
• the hospital or day surgery
• your private health insurance excess or co-payment
• implants, prostheses or specialised devices
• pathology
• radiology or other investigations
• medications and other services.

These services may be provided by independent practitioners or organisations and are therefore not necessarily included in the MIKKO Plastic Surgery quote.

Where possible, our team will help you identify which additional providers you should contact so that you can obtain estimates of their fees before surgery.

Informed financial consent

Informed financial consent means having sufficient information about the expected costs of your treatment before deciding to proceed.

We encourage you to review your written quote carefully and to ask us about anything you do not understand. We also encourage you to contact your private health insurer before surgery to confirm:

• whether you are covered for the proposed procedure
• whether any waiting periods apply
• the benefit payable for the relevant Medicare item numbers
• your hospital excess or co-payment
• whether restrictions or exclusions apply to your policy
• whether your chosen hospital is covered under your policy
• whether any gap-cover arrangements apply.

The Australian Medical Association (AMA) (opens in a new tab) publishes an independent Guide to Informed Financial Consent, which explains medical fees, Medicare and private health insurance benefits and out-of-pocket expenses. The guide is available to AMA members.

We encourage patients undergoing private hospital treatment to read this information and to ask questions about costs before proceeding.

Medicare, private health insurance and the gap

It is important to understand that the Medicare Benefits Schedule (MBS) fee is not the same thing as the fee a doctor is required to charge. Doctors in private practice determine their own professional fees.

For eligible medical treatment provided to a privately insured patient in hospital, Medicare and your private health insurer may contribute towards your doctor's fee. However, their combined benefit may be less than the doctor's actual fee.

The difference between the fee charged and the benefits paid by Medicare and your health insurer is commonly referred to as the gap or out-of-pocket cost.

The size of the gap depends on the procedure, the professional fee, applicable Medicare item numbers, your health fund and your particular insurance policy.

The AMA Fees List

The Australian Medical Association publishes a List of Medical Services and Fees, commonly known as the AMA Fees List. It is intended to assist medical practitioners in assessing the costs associated with providing medical services and in determining their professional fees.

The AMA fee is not the Medicare fee.

The Medicare Benefits Schedule determines the fee on which Medicare benefits are calculated. The AMA Fees List is a separate reference used by medical practitioners for costing and fee guidance.

The AMA itself states that its Fees List is provided for costing assistance and guidance and that individual medical practitioners remain responsible for determining what they consider to be a fair and reasonable fee for the service provided.

Consequently, the amount reimbursed by Medicare or your health insurer may be substantially less than the surgeon's professional fee. We believe it is preferable for patients to understand this difference before surgery rather than receiving an unexpected out-of-pocket expense afterwards.

Health fund gaps

Private health insurance does not necessarily mean that your surgery will have no out-of-pocket costs.

If your procedure is medically necessary, has an applicable Medicare item number and is covered by your private hospital insurance, Medicare and your health fund may contribute towards eligible medical and hospital costs. However, you may still have expenses including:

• the gap on your surgeon's fee
• the anaesthetist's gap
• an assistant surgeon's gap
• your hospital excess
• hospital co-payments
• items or services not covered by your insurance policy.

Your surgeon, anaesthetist and assistant surgeon are independent medical practitioners and may each determine their own fees. For this reason, a quote from MIKKO Plastic Surgery should not be interpreted as a quote for the entire cost of your hospital admission.

We recommend obtaining financial information from all relevant providers before proceeding.

Cosmetic surgery and health insurance

There is an important distinction between medically necessary or reconstructive surgery and purely cosmetic surgery. Medicare and private health insurance generally do not contribute towards procedures performed solely for cosmetic purposes.

Some plastic surgery procedures may attract a Medicare benefit when specific clinical criteria are satisfied. The fact that a procedure can be performed for either cosmetic or reconstructive reasons does not automatically make it eligible for Medicare or private health insurance.

Your surgeon can advise whether your clinical circumstances may satisfy the relevant Medicare criteria, but your health fund determines the benefits available under your individual policy. We therefore recommend confirming your coverage directly with your insurer before surgery.

Deposits and payment for surgery

Once you have decided to proceed, you will be provided with information about booking your operation and payment arrangements.

For cosmetic surgery, Australian Medical Board requirements include a mandatory cooling-off period. Other than fees for initial consultations, no payment or surgical deposit can be required until the applicable cooling-off period has been completed.

For adult cosmetic surgery, there must be a cooling-off period of at least seven days after the required consultations have occurred and informed consent has been provided before the surgery can be booked or a deposit paid.

After the applicable cooling-off period, a deposit may be required to secure your surgical date. The amount of the deposit, payment schedule and applicable cancellation or rescheduling conditions will be clearly communicated to you before payment.

Payment of a deposit does not alter your right to ask further questions about your treatment or to reconsider your decision to undergo surgery.

If your surgical plan changes

A surgical quote is based on the information available and the treatment proposed at the time it is prepared. Occasionally, additional treatment may become necessary because of an unexpected clinical finding, a complication or another change in circumstances.

Where a planned change to your treatment is proposed before surgery, we will discuss the clinical and financial implications with you and provide updated financial information where appropriate.

In an emergency or unexpected clinical situation, it may not always be possible to obtain financial consent before necessary medical treatment is provided.

Questions about costs are welcome

We encourage you to ask questions about fees. Before surgery, you should feel comfortable asking:

• What is my surgeon's fee?
• What Medicare rebate, if any, might apply?
• What will my health fund contribute?
• What will my estimated gap be?
• Is the anaesthetist's fee separate?
• Is there an assistant surgeon's fee?
• What will the hospital charge?
• Will I have a hospital excess?
• Are implants or prostheses included?
• What happens financially if my operation needs to be changed?
• Are there costs associated with revision surgery or treatment of complications?

If you are unsure about any aspect of your quote, please contact MIKKO Plastic Surgery before making payment or proceeding with surgery. We would prefer you to ask questions and understand your financial obligations clearly before treatment.

Independent information

For further information about medical fees and out-of-pocket expenses, you may wish to consult:

Australian Medical Association (AMA)

The AMA (opens in a new tab) publishes a Guide to Informed Financial Consent for its members.

Australian Government Department of Health, Disability and Ageing

Information about private health insurance and out-of-pocket medical costs (opens in a new tab).

Australian Government Medical Costs Finder

Information about typical costs for selected medical services (opens in a new tab).

The information above is general information only. Medicare eligibility, private health insurance benefits and out-of-pocket costs depend on the procedure and individual circumstances. Patients should confirm their entitlements directly with Medicare and their private health insurer.