Metal Mouth Message Board

Hi all, hoping another Aussie can help.... I need double jaw surgery but have been told by the surgeon that the cost of the surgery is covered by Medicare BUT just read another post on here that its not fully covered although the post was from '05. Anyone know current situation?

Good on you for having the courage.I am put of by surgery because apparently it may cause nerve damage.

Thanks . I'm excited at the prospect of having a great and functional mouth!

There are risks with everything... If I worried about that I wouldn't leave the house

Hi, I was offered surgery by my orth but decided against it and was informed that medicare do not pay as its classed as a cosmetic procedure. Its stupid really as a bite issue is not cosmetic if it affects the way you eat ect. I was told to expect to pay 5-6k in addition to the braces. Pleaser do not quote me on this as I may well be wrong as looked into it no further after the intial discussion with my ortho. My treatment is now a non surgical plan.

I don't know for sure either but I was reading about similar things and medicare states that all orthodontic work is currently not covered (this included implants and other minor procedures). Your best bet would be to call medicare and just ask them outright what they do and don't cover if anything. I agree that if they don't it's silly because it's not a cosmetic issue at all.

Good luck!

Apart from some special schemes (e.g. the now axed scheme for people with health issues linked to their dental health), work performed by dentists/orthodontists is not covered by medicare.

However SARME, impaction, etc surgery does attract a medicare benefit, which means that IN THEORY you can have this surgery in a public hospital at no charge but if you managed to score that you would have to pay all orthodontist fees (plus probably some gap fees on out of hospital consultations with your surgeon). You would have no choice of surgeon (although it could be a top notch operator) which can be really important.

Like I said the above is IN THEORY. You'd need to be able to get on some kind of waiting list etc. I have no knowledge what the situation is with regards to oral and maxillofacial surgery units in public hospitals - you can call them and find out. But I suspect they are under pressure fixing the faces of people smashed up by drunks.

If you have private hospital insurance (budget hospital only for say $900 per year), your in-hospital costs would be:
-Hospital excess plus maybe some incidentals.
-Surgeon fee less the scheduled fee set by govt.
-Anesthetist fee less the scheduled fee set by govt.

The scheduled fee is poor for pretty much everything and so the gaps are quite nasty.

Note that private hospital insurance only pays out for procedures which attract a medicare benefit so for private hospital insurance to cover it, medicare has to cover it. So don't let anyone tell you it is only covered by private hospital insurance, except if they include the rider "in practice".

Thanks all.. I'm having the orthodontic treatment and surgery all for free because it's ortho students and the surgery is free because my bite affects my breathing.

I just had the surgery in NSW (upper and lower jaw brought forward - no genioplasty)I have private health insurance (HCF) and here's what it cost me:

Braces - $8000 HCF reimbursed $1700
Hospital - HCF covered everything except $250 + $25 pharmaceuticals
Surgeons (I also had to have an assistant surgeon) $7500 + $3500 - Medicare and private heath reimbursed $2400

My private Health also costs me approximately $3500 per year (with dental)

I also had to have a Lefort and one wisdom tooth removed 10 months prior to the main surgery. This cost around $3500 with maybe $400 reimbursed.

So all up, it cost $18,275 after all reimbursements and NOT counting my yearly insurance bills.