I had 3 Caesarian and my Abdominal wall has torn , now my incontinence is weak and my back is sore. Is it covered under Medicare?
Thank you for reaching out to us here at Ask ASAPS. My name is Dr Gary Avery and I am a Specialist Plastic Surgeon.
The abdominoplasty procedure is certainly one that you would benefit undergoing given the symptoms that you described, however, under the revised Medicare rules, the symptoms that you describe are not currently covered. Medicare made changes several years ago to the criteria for the abdominoplasty procedure – Medicare #30177 – that restricted it use on patients who are very similar to you. They now focus more on massive weight loss patients who are undergoing the procedure for removal of excess skin, rather than treat the other symptoms you describe. This is very unfortunate and I am aware of some recommendations by surgeons and associations representing surgeons, being made to Medicare to amend these rules.
So, this means that should you decide to go ahead with an abdominoplasty, with what you have described, you will not meet the criteria and be considered a self-funded patient with Medicare or health funds not covering the procedure.
Dr Gary Avery
Thanks for your question.
Unfortunately the Government changed the rules back in 2016 and made it a lot harder for mums to get help with muscle repair following babies!
As a group of Specialist Plastic Surgeons we have tried to change this unfair discrimination against mums as currently they can only access a Medicare rebate and health fund assistance if they can demonstrate significant weight loss causing health issues such as chronic skin infections from excess skin.
I contributed to a national study, along with 8 other Australian Specialist Plastic Surgeons, which was published in the American Society of Plastic Surgeon’s ‘Plastic and Reconstructive Journal’ on the functional benefits of tummy tucks. It clearly demonstrates the benefits of the procedure to reduce back pain and incontinence based on the experience of over 200 of our patients.
I'm not sure if links work properly on this site, but the research is here if it is something you want to pursue with your local federal member of parliament: https://journals.lww.com/plasreconsurg/Fulltext/2018/03000/Abdominoplasty_Improves_Low_Back_Pain_and_Urinary.13.aspx
We are hoping this research is able to convince the Federal Health Minister to overturn a 2016 ban on Medicare support for mothers seeking abdominoplasty! We keep hearing updates that the Government has accepted the science, but giving the funding is another issue.
Sorry the news isn't better at this stage.
Kind regards Dr Nick Moncrieff