OSHC & OVHC Coverage for Elective and Cosmetic Procedures: What’s Covered and What’s Not

Why It Matters?

If you’re studying or working in Australia on a temporary visa, maintaining valid Overseas Student Health Cover (OSHC) or Overseas Visitor Health Cover (OVHC) isn’t optional - it’s a visa condition (8501).

These covers help protect you from unexpected hospital and medical costs while meeting Department of Home Affairs requirements.

But many newcomers wonder:

“Does my OSHC or OVHC pay for elective or cosmetic surgery?”

The short answer is no - unless it’s medically necessary.

Understanding Elective vs Cosmetic Procedures

Type	Meaning	Typical Examples
Elective procedures	Non-emergency surgeries scheduled in advance but still medically required.	Hernia repair, gall-bladder removal, knee arthroscopy
Cosmetic surgeries	Performed primarily to alter appearance rather than restore function.	Rhinoplasty for appearance, liposuction, breast augmentation, Botox

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Under the OSHC Deed (2025) and all insurer fund rules, treatment must be clinically necessary to attract any benefit. Purely aesthetic procedures are automatically excluded.

Does OSHC Cover Elective or Cosmetic Procedures?

Usually no.

OSHC covers only hospital and medical services that a doctor deems necessary to treat or manage a medical condition - not procedures chosen for cosmetic reasons.

Generally covered under OSHC:

GP and specialist consultations
In-hospital treatment for illness or injury
Medically necessary surgery
Prescription medicines (subject to limits)
Emergency ambulance transport

Excluded under OSHC:

Cosmetic or elective procedures without medical need
Services performed solely for appearance change
Dental, optical or physiotherapy unless you buy Extras cover

Insurers such as Allianz Care Australia, Bupa, Medibank, ahm, nib and AIA (OVHC only) may pay benefits if the surgery is reconstructive after an accident or illness, provided medical documentation supports necessity.

Does OVHC Cover Elective or Cosmetic Procedures?

For temporary workers, visitors or dependants, OVHC fund rules mirror OSHC principles

They cover medically required hospital and doctor services, not optional procedures.

Typically included:

In-hospital treatment for illness or injury
Day surgery that is medically justified
GP and specialist consultations (according to level of cover)
Emergency ambulance

Commonly excluded:

Cosmetic surgery unless reconstructive after trauma
Elective procedures performed by choice
Experimental or unapproved treatments

When Cosmetic Surgery May Be Covered?

A procedure that seems “cosmetic” can be covered if it restores normal function or treats damage caused by disease or injury.

Examples include:

Breast reconstruction after mastectomy
Skin grafts after burns or accident
Rhinoplasty to correct breathing impairment
Jaw reconstruction following trauma

Insurers will require:

Supporting medical reports
Pre-approval before hospital admission

How to Check If Your Procedure Is Covered

Contact your insurer directly - Bupa, nib, Medibank, ahm, Allianz Care Australia or AIA (OVHC).
Ask for the Medicare or health item numbers from your surgeon.
Provide a quote and medical justification for assessment.
Review the PDS and Fund Rules sections titled “Exclusions” or “Hospital Services.”

Common FAQs

Are cosmetic surgeries covered under OSHC or OVHC?
‍No. They are classified as non-essential and elective. Coverage applies only to procedures that a doctor certifies as medically necessary.
What if I need reconstructive surgery after an accident?
‍If the aim is to restore physical function or appearance after injury or illness, it may be covered once approved by your insurer and supported by medical evidence.
Can I upgrade my policy for cosmetic coverage?
‍No OSHC or OVHC policy includes optional cosmetic benefits. Only Australian private health insurance (for citizens or PR holders) may offer limited extras for certain treatments.
Are LASIK or dental implants covered?
‍No. They’re classed as elective and fall outside standard OSHC and OVHC benefits. Separate Extras or private cover is needed.
What should I do before booking surgery in Australia?
‍Ask your doctor for a detailed quote and item numbers, then contact your insurer for written confirmation of benefit eligibility before you proceed.

Comparing OSHC and OVHC Plans Smartly

At GetMyPolicy.online you can compare quotes and inclusions from major Australian health insurers - Bupa, Allianz Care Australia, Medibank, ahm, nib, and AIA - all in one place.