So for those of you out there who are looking into SARME/SARPE, orthodontics and bi-max surgery - here is the cost for each stage along with a breakdown of what fees make up the total. All prices are in Australian dollars before any rebates from my private health fund or Medicare.
Stage 1 SARME = $6,250
Surgical fee = $3,000
Teeth removed x 5 = $550 (total)
Day surgery fees = $1,800
Anaesthetist fees = $900
Stage 2 Orthodontics = $10,800
Braces, adjustments and all appointment fees = $10,800 ($3750 initial deposit then $470 per month for 15 months).
While the orthodontics sound expensive this also includes consultations for two years after orthodontic work is completed.
Stage 3 Bi-maxillary (double jaw) surgery = $23,000 (approx.)
Pre-op surgical appointment = $1,500 (approx)
Surgical fees = $17,000
Surgical fees = $17,000
Hospital and anaesthetist fees including 1 night high dependency unit and five night stay total = $4,000 (approx.)
Other fees for x-rays, consults, veneers, cleaning and general dental = $3,000 (approx.)
Expensive? Well yes it is - but remember these fees are before any health fund or Medicare rebates. I can expect to receive about $8,000 in total from these rebates. Then there are the tax refunds on top of that - the Australian government will give 20% back on all medical expenses over $2,200 in any tax year (after rebates from health funds and Medicare). The cost of these procedures will be spread over two years, but I can still expect to receive another $5,000 or so back, which brings the grand total out of pocket to around $27,000 which is much more manageable.
If you are still reading but unsure of the prices I think its a matter of putting things into perspective. Some people would not think twice about spending this much money on a brand new car. Some people will easily spend $10K on an overseas holiday. This is something that will last me for the rest of my life, so I definitely think it is a wise investment.
Well that's all for now - it's late here in Sydney and time for bed. If you have any questions feel free to drop me a line or leave a comment.
Hi Andy,
ReplyDeleteThanks for your blog this is really helpful. I am currently considering bi-maxillary jaw surgery and orthodontics in Sydney and trying to figure out the cost!
Do you mind if I ask what health fund you are with? Mine only seems to rebate $500 for oral surgery and $2,500 for orthodontics so that is making me nervous as a good rebate would help!
Many thanks, Louise
Hi Louise
DeleteSorry for responding to your comment so late - it's been a really busy couple of weeks.
I'm with HIF and they gave me $2,000 towards orthodontics. To be honest I'm not really sure at this stage how much they will pay towards the bi-max, but you should remember that Medicare pay a good benefit as well. And then your health fund will also pay towards the hospital and anaesthetic part of the surgery too.
From what I can gather when I wrote this post, and info from my surgeon - I think the bi-maz leaves you around $15,000 out of pocket. Depends on what is involved with each case though.
I hope this has been a help. I think its a much better investment than a car and people (including me) could easily spend more on a car. :)
Hi Andy, first of all thank you for your blog extremely helpful and sorry for my english but I m learning.
DeleteI m italian and I m 30, it is a life I m waiting to do your same surgery and now I m in Sydney w a sponsorship so I can't go back in Italy to do it , it s really important for me to start now and put the word end to this problem which influenced my entire life and go back to smile to the people and for the first time feel confident so I decided to do it here knowing I will have to pay all the process entirely without receive any money back. I don't know where I can start and which doctor to trust so I thought that the best way was to contact someone who has already done this surgery here for help, any kind we can meet up somewhere for a coffee or if you could direct me in the right way. Thank you very much. It is really important.
Hi Giacomo
DeleteSorry for the late reply. I am now only just eating to the comments and updating the blog after far too long. Did you decide to go ahead with this yet or find someone?
Andy
Hi Andy
ReplyDeleteWe are both pretty much in the same boat, and I am also from Sydney. After numerous bone scans and further tests/investigations since my jaw's bone growth isn't fully stable for the last two years, I was just given yesterday a go signal by my oral surgeon from Westmead Hospital to start now the orthodontic treatment. I was told yesterday that by the time I had the braces, I should have extraction of third molars (or wisdom teeth) and SARME to expand my maxillary arch within the first three months of having braces then I will have a bimaxillary osteotomy (jaw surgery) after 12 months.
However since I have started visiting my oral surgeon at Westmead Hospital since 2011 for consultations and investigations, I haven't paid anything, not even a single cent, and is fully covered by Medicare. My surgeon also told me that the third molars extraction, SARME and the whole jaw surgery itself will be covered by medicare through the public health system. I have private insurance, but my surgeon advise me to just do it in a public hospital to avoid out of pocket expenses. And he said that because it is a long treatment plan, we can arrange a date for surgery for next year as early as now so lining up in the waiting list will not be an issue since that jaw surgery is supposed to be done next year anyway. I only have to pay for the braces itself since it is a private practice.
Is your oral surgeon based on a private clinic? If so, you might save yourself a massive $30,000 if you go to the same hospital I am going and pretty much get the same treatment.
Nonetheless, I will keep visiting your blog and keep us updated. I am also thinking of putting up a blog for my jaw surgery journey so to speak. Might also consider joining and participating in online community of jaw surgery patients. Let's inspire each other! Am sure it's gonna be worth it in the end! :)
Kristian
Hi Kristian
DeleteI was very interested to ready your comment and am pretty sure that your oral surgeon has given you some incorrect information or that maybe you have mis-understood what he has said. I have done lots of research on on public vs private treatment and unless you fall into a special income bracket or special category in terms of medicare benefits - it is not fully covered. Some areas like braces are not covered by medicare whatsoever.
While your consultation/investigation fees are zero through a public hospital as they are billed to medicare, they only make up a small portion of the overall cost. Neither a SARME or single/double jaw surgery are fully covered by medicare and you would still pay towards surgeons fees, anaesthetic fees and hospital fees. The amount you pay may be slightly less through a public hospital, but from my investigations and sums it is only a saving of around 10% and the surgery fees are still almost $15000. The best thing to do is ask your surgeon for the medicare item numbers which will be charged, how much the fees will be for each item and then check the Medicare Benefits Schedule available on the medicare Australia website. This will show you the full rebate payable for each item and if the charges are higher than the rebate amount, you will pay the gap.
Also, braces carry no medicare benefit at all and are ONLY covered by private health insurance. If you need braces, you will end up paying for them. Braces cost around $11,000 and private health insurance only covers around $1500-$3000 of this cost depending on your cover and the length of time you have held it. The Medicare Benefits Schedule clearly states there is no rebate on orthodontics, unless again you fall into a certain category.
My only final bit of advice is to choose your surgeon rather than choose your price. This surgery as I am sure you are aware is a huge decision and is something that will last for the rest of your life. I originally started with a public hospital but went with a private surgeon due to his reputation, number of surgeries completed each year and success rate. While a lower charge may be tempting, I don't think it should be the main driver of your decision.
Just my advice - feel free to drop me a line if you would like to chat more.
Andy
Hey Andy
ReplyDeleteI am sure everything will be fully covered by Medicare (of except the braces) as I have asked this same question numerous times and in different occasions to my oral surgeon.
Did you also paid to xrays/scans etc? Mine was fully covered as well. I have done three bone scans, 2 xrays and several consultations and haven't paid anything not even a single cent - just have to show my Medicare card. I have even asked my surgeon straightforward, as in like "Is the jaw surgery and the whole treatment will be fully covered by Medicare?" And he answered "Yes", then I ask again "So it means I will not be out of pocket or wont have to pay a gap?" And he answered "yes, that will be the case if I do it in a public hospital, but ig you decide to do it in a private hospital then you might incur a gap." Those are his exact words. He even joked on me that I can pay him some beer if I want to, so I am pretty sure it will be covered as it is a corrective jaw surgery and not for cosmetic.
Nonetheless, I will follow your advice of getting the item numbers and the actual cost that they will charge and compare that to the medicare schedule.
I did my research too, and I have read on forums that it is actually covered by medicare according to other patients who have finished the whole treatment and surgery.
Anyway, is the SARME painful post surgery? I am quite nervous doing it but I have no doubts of doing the surgery. I am certain that I want to do it. I know it's gonna be worth it!
Hi Kristian
ReplyDeleteIn response to your first question - I did pay for x-rays, but I do understand that it is free if you do this in a public hospital. All I can say for the surgery cost is that I am happy to pay for it, because I would rather choose my surgeon than choose my cost as I mentioned to you earlier. Going for the cheapest option is not always the best.
Regardless of whether you will be charged surgeons fees, you will have out of pocket for hospital, anaesthetic fees, one night stay in high dependency unit (required), four days in regular ward - there is simply no way medicare cover all of this. Not trying to be difficult, but I'm not sure I believe your surgeon and not sure I woud want this done in a public hospital. Make sure you ask the questions about how many surgeries, success rates etc...
Anyhow - SARME is not really painful post surgery - I was absolutely fine and quite surprised at no pain. Make sure you have ots of porridge, soup, ice-cream, yoghurt etc. Also when you first start turning it will be weird, but I am sure you will be absolutely fine :)
When is your SARME?
Hi Andy
ReplyDeleteThere is no date for my SARME yet. I still have to come back to my orthodontist to start with the braces treatment, but my surgeon said that SARME and wisdom teeth extraction should be done in the early stage such as in the first three months of having the braces. I have searched my surgeon's background and he seems to be very experienced as he is on his 50s and he said that he do this surgery a lot of times in a month and it is very common procedure as he has done it many times.
I think if I go to a private hospital I am sure that I will have out of pocket expenses, and that is what my surgeon told me. He said that it's the same thing when I do it in public or private, since it's the same group of doctors who will do the procedure, the only difference is the setting such that it is in a private hospital where you enjoy the luxury of being in a private such as quality meals, facilities, etc. I have private insurance but maybe I'll just go to a public hospital to get it done as advised by my surgeon.
I have read your post about your SARME procedure, and it seems that the effect is that it created a massive gap in your teeth right in the middle. How long does it take before that gap completely closed or at least diminished? Do you feel any pressure in your mouth every time you make a turn? Do you feel paranoid at times that you might accidentally swallow the expander? Oh geezzz those are my worries! I'm not too scared with the surgery thing to be honest as I had two surgeries before for a different medical condition so I kind of like know what to expect somehow during and after surgery.
Kristian
Hi Kristian
DeleteWho is your surgeon that you will use at Westmead Hospital?
Thanks,
Like Andy I thought there was a minimal difference in cost going public.
DeleteIf you're saying it's free, can you tell me the surgeons name so I can book an appointment asap - I have to hear it for myself.
Hi Kristian, my 14 year old son needs surgery and it sounds very similar to your order of things to be done.
DeleteAm wondering if you have had it yet and was it painful, gap etc.
I'm a worried mother and a bit freaked at the thought of what he has to go through so any information would be most welcome.
Hi Kristian,
DeleteCan I have the name of this orthodontist/oral surgeon at Westmead? Thank you! Annie
Hi Andy,
ReplyDeleteI am a 22 year old woman and I've struggled pretty much my whole life with my asymmetrical jaw which also affects eating and clicks a lot. I was told that I could have surgery to correct this however once I finished treatment with braces it all got a bit forgotten about.
I really want to get this surgery however before I book an appointment with my orthodontist to get a referral I'm wondering how did you go about paying for your surgery, and did medicare cover any of it or was it just through private health fund? as it is only lower jaw do you have a rough idea of what that might cost?
sorry if you've already explained above I just wanted to make contact and find out a bit more about your experiences, as I am at a bit of a loss as to how to go about this whole thing.
Hi Andy
ReplyDeleteI am 25 years old man and i want to move my lower jaw a bit forward, may be less than an inch. How much it will cost to me? Please reply me. Thanks for a good blog.
Sorry, wisdom tooth extraction is covered with a healthcare card*
ReplyDeleteHi
ReplyDeleteI had the bimax surgery done as well and i am on top extras cover however the 'major dental' part apparently is not claimable for this surgery unless teeth were extracted.
Hi!!
ReplyDelete