Understanding the cost of weight loss and general surgery in Australia — Medicare, private health insurance, and what to expect at every stage.
Important: All surgery costs are individual. A personalised Informed Financial Consent (IFC) with your exact fees, Medicare rebates, and out-of-pocket estimate will be provided before any procedure is booked.
Bariatric and general surgical procedures in Australia involve several funding components. Understanding these helps you plan confidently.
Medicare provides rebates for the surgeon's fee, physician's fee, and anaesthetist's fee for eligible procedures. This is a contribution — not full coverage. The Medicare Benefits Schedule (MBS) item numbers apply to specific procedures when clinically indicated.
Who qualifies: All Australian residents with a Medicare card. A GP referral helps maximise Medicare rebates, though you can see Dr Keeley directly without one to get started.
Private hospital insurance covers hospital costs — ward fees, theatre fees, and equipment. Without it, hospital costs are paid out-of-pocket. The level of cover and excess varies significantly between funds and policies.
What you need: A Gold-tier hospital policy that specifically includes bariatric (weight loss) surgery. Check with your fund before booking.
The "gap" is the difference between what Medicare + health insurance pays and the total fee charged. This varies by surgeon, anaesthetist, and procedure complexity. You will receive a full IFC document showing your exact estimated gap before surgery is booked.
Tip: Ask our team for the MBS item numbers so you can check your fund's benefits before your consultation.
The following provides a general guide only. Actual costs depend on your health fund, level of cover, excess, clinical complexity, and hospital fees.
| Procedure | Medicare Rebate | Health Insurance | Hospital Stay | Typical Gap* |
|---|---|---|---|---|
| Gastric Sleeve (Sleeve Gastrectomy) | Yes ✓ | Gold tier required | 2–3 nights | Consult for quote |
| Gastric Bypass (Roux-en-Y) | Yes ✓ | Gold tier required | 3–4 nights | Consult for quote |
| Revisional Bariatric Surgery | Yes ✓ | Gold tier required | Varies | Consult for quote |
| Procedure | Medicare Rebate | Health Insurance | Out-of-Pocket |
|---|---|---|---|
| Colonoscopy No-Gap | Yes ✓ | Any hospital cover | $0 for eligible patients |
| Gastroscopy No-Gap | Yes ✓ | Any hospital cover | $0 for eligible patients |
| Procedure | Medicare Rebate | Health Insurance | Hospital Stay |
|---|---|---|---|
| Laparoscopic Cholecystectomy | Yes ✓ | Any hospital cover | Day or 1 night |
| Laparoscopic Hernia Repair | Yes ✓ | Any hospital cover | Day or 1 night |
| Anti-Reflux Surgery (Fundoplication) | Yes ✓ | Any hospital cover | 2–3 nights |
| Laparoscopic Appendicectomy | Yes ✓ | Any hospital cover | 1–2 nights |
* All costs are indicative only and vary by individual health fund, level of cover, fund excess, and clinical complexity. A full Informed Financial Consent document will be provided before any procedure is booked.
Before booking your consultation, we recommend confirming the following with your health fund:
You'll need a Gold-tier hospital policy for bariatric (weight loss) surgery. Basic, Bronze, and Silver tiers do not cover this category.
Most funds impose a 12-month waiting period for weight loss surgery if not included when you first joined. Check whether you've already served this period.
Your excess is the amount you pay per admission or per year. This is deducted from your hospital cover and paid directly to the hospital.
Some funds have "known gap" or "no-gap" arrangements with surgeons. Ask your fund if Dr Florica participates in any such scheme.
Medicare rebates for bariatric surgery apply to several fee components:
Tip: You can look up the Medicare schedule fee for specific item numbers at the MBS Online website. Ask our team for the relevant item numbers for your procedure.
No-gap endoscopy: Colonoscopy and gastroscopy are available no-gap for eligible privately insured patients — $0 out-of-pocket for the procedure itself.
Pricing Disclaimer: All cost information on this page is general guidance only and does not constitute a quote or financial advice. Actual costs depend on your individual health fund, level of cover, excess, clinical complexity, and the fees of other treating practitioners (anaesthetist, assistant). A personalised Informed Financial Consent document will be provided prior to any procedure. We are not financial advisors — please contact your health fund and/or a financial adviser for specific advice.
Book a consultation with our team. We'll prepare a detailed Informed Financial Consent so you know exactly what to expect — no surprises.