State of the Nation - Question waiting times

Hi Kirsten, thank you for your efforts to understand more about this issue. I had a delayed (2yrs) after mastectomy, unilateral DIEP reconstruction in 2014 at Prince of Wales Private. I delayed my reconstruction due to uncertainty around treatment and the fact I needed some time to heal and prepare for that kind of surgery. At that time, DIEPs were not offered on the Central Coast, (where I live), so I needed to travel for this type of surgery, which was the one recommended to me by my breast surgeon (also at POW) due to skin issues / scarring from radiation. When I met with my plastic surgeon I was offered either public or private options and initially was put on the POW public private list. However, the wait was at least 365 days (Category 3) and so I decided to go private in order to be more in control of the timing and to ensure I had the surgeon I wanted. We have top level private cover but there was still a signifcant gap (around $8,000).

For the further two surgeries I required as part of the reconstruction process (1 revision/ breast lift of the other side and nipple reconstruction), I again went private, but was able to negotiate no gap. However, with the revision / breast lift and the nipple reconstruction I did have to argue with my private health insurer that it was not cosmetic surgery, but was part of the reconstructive process, which was an extremely stressful and upsetting thing to be doing. Eventually (with my surgeon's support) they agreed, but I am aware that this situation is not uncommon and may be one of the reasons that some women either forego reconstruction all together, or opt to sit on a public waiting list for years.