Cover for back and spinal surgery with Australian Unity.
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Price based on :
Singles cover in VIC. I'm Under 65 with an income $105,000 or less, Rebate Tier 0 and a 4% discount for direct debit.
Spinal surgery, sometimes referred to as back or neck surgery, includes procedures used to treat conditions affecting the spine, spinal cord and surrounding nerves. Your doctor may recommend spinal surgery when other treatments, such as physiotherapy, medication or lifestyle changes, haven't provided enough relief.
Common reasons for spinal surgery include:
Depending on your condition, your specialist may recommend:
Yes. Spinal and back surgery may be covered by some private hospital insurance. In most cases, spinal and back surgery is covered under the Back, Neck and Spine clinical category, but this will depend on the MBS item number(s) used by your doctor for the procedure. Your policy must include the relevant clinical category, and you must have served any applicable waiting periods.
Depending on your cover, benefits may be payable towards:
It's important to remember that out-of-pocket expenses may still apply. These can include specialist gap fees, anaesthetist charges and excess payments, depending on your policy and healthcare providers.
Before booking treatment, you should contact us to ask about the benefits you can expect to receive and any out-of-pocket expenses you might incur.
Spinal surgery is generally covered under Hospital cover, not Extras cover. In Australia's private health insurance system, spinal surgery is included within the Back, Neck and Spine clinical category, which is a Silver-tier category under the private health insurance tiering system. This means spinal surgery benefits are generally available through Silver and Gold Hospital cover. Always check your policy to confirm what's included.
Can Extras cover help?
While Extras cover doesn't pay for spinal surgery performed in hospital, it may help with eligible services that support your recovery before or after surgery, such as physiotherapy and other out-of-hospital treatments included under your policy. Hospital and Extras cover can work together to support different parts of your healthcare journey.
If you need back or spinal surgery, understanding the difference between Medicare and private health insurance can help you make an informed decision. While Medicare provides access to treatment through the public healthcare system, private health insurance may offer greater choice over the hospital and specialist, depending on your cover.
| Medicare (Public System) | Health insurance with spinal surgery cover | |
|---|---|---|
| When you can have treatment | Treatment is subject to public hospital waiting lists, which can sometimes be lengthy. | Treatment may be available sooner. If you haven't previously held cover that includes Back, Neck and Spine, you may need to serve a waiting period. After that, you'll generally have more flexibility when choosing a hospital and specialist. |
| Where you can have treatment | Public hospitals allocated through the public healthcare system. | Choice of participating private hospitals and, in some cases, public hospitals. |
| Who can treat you | Limited ability to choose your specialist. | Greater choice of specialist and treating team. |
| Cost to have the surgery | No hospital accommodation charges, surgeon or anaesthetist fees. Although you may still incur costs for appointments, tests or medications outside your hospital stay. | Depending on your policy, you may pay an excess or co-payment. Out-of-pocket costs may also apply for services provided by your surgeon or anaesthetist, as well as out-of-hospital appointments. |
The cost of spinal surgery in Australia can vary significantly depending on:
Every patient's circumstances are different, so it's important to obtain a detailed quote from your specialist before treatment.
The cost of spinal surgery can vary depending on the procedure you need, the hospital you choose and the specialists involved in your care. Private health insurance may help cover hospital costs related to spinal surgery if the treatment is included in your cover and you've served any applicable waiting periods.
You may still have some out-of-pocket expenses, such as:
Before proceeding with treatment, ask your surgeon for informed financial consent so you understand any costs you may need to pay. Eligible Australian Unity members can also access Gap Cover, which may help reduce or eliminate some out-of-pocket specialist costs when participating doctors use the scheme.
Yes, if your spinal surgery is covered under your Hospital cover (look for Back, Neck and Spine) we generally cover you for Australian Government approved prostheses, including spinal implants, on the Australian Government’s Prostheses List (also known as the Prescribed List of Medical Devices and Human Tissue Products), which must be surgically implanted during a stay in hospital. You’re covered for all prostheses on the List, up to the value stated on the list. You’ll have an out-of-pocket expense where (in consultation with your doctor) you choose a prosthesis that isn’t included in the Government’s list at all. In that case, we won’t pay any benefits and you’ll be responsible for the full cost of the item. Your doctor should discuss your prosthesis options with you and seek your Informed Financial Consent regarding additional costs you may have to pay.
Waiting periods may apply before you can claim benefits for spinal surgery.
For most new Hospital cover policies:
A pre-existing condition is an illness, condition or ailment where signs or symptoms existed during the six months before you joined or upgraded your cover, whether or not you had received a diagnosis at the time.
The best private health insurance for back surgery will depend on the type of procedure you're having and the level of Hospital cover you hold.
When comparing cover, look for policies that include the Back, Neck and Spine clinical category, which is a mandatory Silver-tier category under Australia's private health insurance system.
It's also worth considering:
