Does Medicare cover weight loss surgery in Australia?
Whilst Medicare recognises bariatric surgery as an established medical treatment in Australia, the surgery itself is not performed much in the public health system for various reasons. Top cover health insurance is generally required for bariatric surgery to be performed in a private hospital. You can contact your insurance company and quote the following items to see if you are eligible:
- Gastric Sleeve – 31575
- Gastric Bypass – 31572
Alternatively superannuation can be used for patients to cover the costs of bariatric surgery if they are deemed medically eligible here
Please feel free to contact our admin/finance team if you have any further questions.
How much does weight loss surgery cost in Australia?
SBC offers affordable pricing for their bariatric surgeries so that more patients can have access to life-changing surgery. A program fee is charged that covers the entire treatment and multidisciplinary care.
The fee for SBC with private health insurance is approximately $5,800. Private health insurance will cover your hospital costs.
The fee without private health insurance is from $8,500 (excluding all hospital costs, which will be quoted by the hospital after your first appointment).
Early Release of Superannuation can be accessed on medical grounds to help cover some or all of the costs of bariatric surgery. The application for early superannuation release is processed through the Australian Tax Office. You will need to fill in an
application form and obtain a letter of support from both your GP and specialist.
Claire and Amanda, our accounts and nursing team can assist you and walk you through this process to make it as simple as possible.
If I don’t have private health insurance how can I pay for surgery?
Because most bariatric operations take place in a private hospital, this will involve some degree of cost to you as a patient.
In general most patients will go through their private health fund to assist with this cost. However it is still possible to have surgery done privately if you don’t have private health cover.
This comes under the banner of being “self-funded” where all the costs of both the medical care and the hospital stay are incurred by you as the patient.
Quotes will be provided to you for both the medical clinic’s costs (Sydney Bariatric Clinic in this case) and the private hospital’s fee (E.g. Westmead Private or Lakeview Private Hospital). This has to be paid by you in total.
One option to cover the costs of the above is to use your superannuation funds if they are sufficient. You can apply for early release of superannuation under medical/compassionate grounds. Early release of super is taxed through the ATO at 22%.
At Sydney Bariatric Clinic our reception and accounts staff will be able to help you with all the paperwork necessary for the super application. Alternatively you can call the ATO on 132010 for any further enquiries.
Am I a candidate for weight loss surgery in Australia?
Sydney Bariatric Clinic is a multi-disciplinary center that provides a non-judgmental, professional service to help patients achieve long-term success with weight loss surgery.
If you have been trying to lose weight for over 2 years through diet and exercise programs and/or through medications without success, you can be considered for weight loss surgery if :
- Your Body Mass Index (BMI) is greater than 35 alone (See About Weight Loss Surgery for calculator)
- Your Body Mass Index (BMI) is 30 or more and you have any one of the following medical conditions:
- Diabetes
- High Blood Pressure
- Heart disease
- Sleep Apnoea
- Chronic Joint pain / arthritis
- Depression or Anxiety
- Asthma
- GORD
- PCOS
- Infertility
- Severe leg swelling
- Benign Intracranial Hypertension
- Fatty Liver disease
- Chronic Kidney disease
- Other medical conditions
These are guidelines of course and surgery can sometimes be considered outside these guidelines – for example for different ethnic groups the BMI changes and the severity of medical condition is a significant factor.
Deciding whether or not to undergo bariatric surgery is a big decision. Chances are if you have looked through our website, you are thinking about it. If you are unsure the best way to determine if you are suitable is to have a consultation with Dr Ryan or one of our other specialist Doctors by arranging an appointment .
Is Weight Loss Surgery recommended for other medical conditions?
Carrying excess weight can lead to and make worse a number of medical conditions such as diabetes, heart disease, hypertension, sleep apnoea, asthma, chronic joint pain, PCOS, insulin resistance, fatty liver, infertility, GORD (reflux/heartburn), depression and anxiety, general tiredness and lethargy, lower leg swelling, varicose veins, incontinence, increased risk of cancer such as uterine, breast and bowel cancer and so on.
You might come across the term ‘comorbidity’ when researching bariatric surgery. A comorbidity is a disease that is the result of, or strongly related to, a primary disease. In the case of bariatric surgery, the primary condition is obesity and the comorbidities may be conditions like type 2 diabetes, sleep apnoea, chronic joint pain and many more.
Having bariatric surgery will likely completely resolve or at least greatly reduce the burden of your comorbidities. For example, gastric bypass surgery typically resolves type 2 diabetes in most cases. We understand that every person is different and that bariatric surgery is not one size fits all. This is why we have a multidisciplinary team which works closely together to ensure that you are receiving care for all aspects of your health (not just your weight).
Contact our friendly team to find out more about how bariatric surgery can help with other medical conditions you may have. Our knowledgeable team will make sure all of your questions are answered so you can make an informed decision.
What is the safest form of weight loss surgery in Australia?
Bariatric surgery is generally very safe. In terms of what procedure is safest, gastric sleeve and gastric bypass surgeries both have equally low complication rates. Surgical and anaesthetic risk for both of these surgeries is less than 1% at SBC. Gastric Banding although generally a safe operation, is not performed very much now because of the inconsistent and often poor weight loss outcomes. Patients also tend to suffer swallowing difficulties and vomiting.
However at the end of the day all procedures carry a small risk. Thats why it’s important to choose an experienced centre such as Sydney Bariatric Clinic, recognised as a International Centre of Excellence in Bariatric Surgery.
The expertise and experience of your surgeon is the best predictor of how safe your surgery will be. Dr Ryan and the multidisciplinary team at SBC are all highly experienced and perform hundreds of weight loss surgeries each year. You will be in safe hands at each step of your weight loss journey.
What are the different Gastric Bypass options?
There are two types of gastric bypass commonly performed in Australia:
1. Roux-en-Y Gastric bypass (RnY)
2. Mini Gastric bypass (also known as the ‘Omega Loop’ or ‘Single-Anastomosis bypass’ )
Historically the RnY bypass has been performed extensively overseas and often considered the ”standard” bypass as it has been well studied for decades. However the Mini Gastric Bypass has been gaining popularity as a simplified form of gastric bypass with fewer surgical complications and equally effective weight loss.
There is healthy debate as to which form of bypass is the best for patients. Gastric bypass has the highest weight loss statistically with excellent outcomes particularly for type 2 diabetics. Excess weight loss is excellent with many studies reporting 80-90% of excess weight loss at 2 years. Improvement in common health issues such as high blood pressure, sleep apnoea, joint pain and chronic tiredness is very likely.
However, with the use of the bowel to achieve greater weight loss comes a small possibility of nutritional deficiencies and so long term follow-up of gastric bypass patients is vital to prevent secondary complications, such as iron deficiency and osteoporosis. At SBC there is a strong emphasis placed on long term follow-up. We have highly qualified Dietitians who are very experienced with the nutritional requirements of Bariatric patients. We have regular and long term medical, nursing and allied health care for our patients.
At Sydney Bariatric Clinic both types of bypass are offered and your surgeon will be able to go through the pros and cons of each.
What does recovery look like?
Recovery looks different for every person and depends on a number of factors including your state of health pre-surgery, age and mental preparation. A good preparation before the surgery such as taking optifast, reducing smoking etc can lead to improved recovery.
Always follow the advice from your team at SBC. This is very important because it will be tailored to your specific needs. After bariatric surgery, you must totally change how you eat and approach food. It is also important to incorporate exercise into your daily routine.
Diet
Fluid Phase: initially, you can only tolerate fluids in your diet for approximately 2 weeks after surgery. There will be no hunger, and you will be sipping a variety of drinks slowly.
Changing Texture: for a period of 4 – 6 weeks after the liquid phase, you will have changed the texture of your foods by blending, pureeing, and mashing food to make it easier for you to digest these foods and to help recovery.
After your operation, you will have the support from our dietitians to provide you with the right bariatric diet and eating techniques that will help you recover.
Our dietitians will help you with:
- Transitioning to different food textures
- Avoiding complications
- Mindful eating
- Obtaining all the nutrients needed for good health and managing specific health conditions such as type 2 diabetes, coeliac disease, food intolerances, heart or kidney disease.
- Vitamin and mineral supplementation
- Ensuring adequate protein intake
- Meal planning and weight loss goal setting
Exercise
Start walking around as soon as you get home (start with a few minutes a day and build from there). Generally speaking, you should be able to begin working out approximately six weeks after your surgery. It is vital that you incorporate exercise into your daily routine to reduce the chance of regaining weight. Exercising is also a way of maintaining a positive mental state, preserving and building muscle mass which is so critical in the weight loss phase as well as increasing metabolism.
Mental Health
Most people will experience a lift in mood once they see results of major weight loss . Improvement in sleeping, more energy and resolution of things such as blood pressure and sore joints can result in a dramatic improvement in well-being.
However, a small percentage of patients notice depression after having bariatric surgery. You need time to adjust following the procedure and that adjustment period can be difficult. Often people underestimate the mental toll of surgery and only focus on the physical toll. It is important to know that there is nothing wrong with you for feeling this way after surgery and that the team at SBC is here to support you. Make sure you get in contact with us if you notice a change in your mental state after your surgery.
Follow-Up care
The first several months after your surgery will consist of frequent medical checkups to make sure that everything is ok. Our multidisciplinary team will work with you to make sure that you are progressing along nicely and guide you through your recovery process.
How long will recovery take?
Recovery after Laparoscopic (Key-hole) weight-loss surgery is quick with patients out of hospital after 2 to 3 days on average.
Patients are able to get up and walk the same day after surgery and encouraged to walk up and down the corridor the day after surgery.
Nausea can sometimes be an early complaint post-operatively. This can be treated with medications.
Most people are advised to take 2 weeks off work but occasionally there are exceptions depending on the nature of the job. For example a very physical job may need 3 weeks off. Driving a car is usually possible after one week.
We recommend no strenuous activity, heavy lifting or gym for 4-6 weeks after surgery.
There is a graduated diet after the surgery to allow your stomach to heal. At SBC the team including dietitian and nurse will discuss with you in detail the post-op diet of liquids, protein shakes and soft foods.
You can find out more information here about recovering after bariatric surgery. ‘What does recovery look like’. The multidisciplinary team at SBC will make sure your recovery plan is tailored to your needs so you can expect the best health outcomes possible.
