Surgery for a person who is 12 years or older to remove tonsils, or the tonsils and adenoids.
Patient journey
Day of procedure
On the day or days of their Tonsillectomy with or without adenoidectomy (12 years of age and over), patients typically received the following service(s) which may incur separate fees and costs. The timing and need for these services will depend on your own situation. Depending on the procedure you may be admitted to hospital the night before.
Anaesthetist appointment
Anaesthetic services
Operations
Specialist fees
Tonsillectomy with or without adenoidectomy (12 years of age and over)
Before seeing a specialist
If you and your doctor agree on a specialist, your doctor will write a referral to that specialist. You can also talk to your doctor or insurer about other options. This can include getting an open referral(opens in new tab).
The guide to costs page can help you understand what may happen when you visit a specialist and avoid unexpected out-of-pocket costs. Ask a specialist how much an initial appointment will cost.
When seeing a specialist
At your initial appointment, you should receive a customised quote from your specialist. It should detail your specialist’s fees and any out-of-pocket costs you might have to pay for this procedure. Additional fees may be charged based on further investigations and your circumstances.
There should be no extra administrative, booking, or hidden costs applied.
Included
- Specialist fees
Excluded
- Assistant surgeon fees
- Anaesthetist fees
- Hospital fees
Your private health insurer may be able to cover part, or all of these fees, depending on your level of insurance. Talk to them and your specialist about the cost implications.
Typical insurer out-of-pocket costs
Private health insurance can help cover the cost of treatment when you go to hospital as a private patient.
How insurance helps you
There are costs when you go to hospital as a private patient, such as specialist fees and hospital fees. If you are covered under an appropriate policy, your insurer will contribute to these costs.
For specialist fees, your insurer and Medicare will pay a set amount. You will pay the difference, or gap, out of pocket.
You may be eligible for a gap arrangement depending on your insurer and specialist which can reduce your out-of-pocket cost. These can vary between patients.
Hospital fees are generally covered by your insurer if they have an agreement with the hospital. Other fees may be covered depending on your policy. Confirm this with your insurer.
Your policy may require you to contribute to your hospital admission via an excess or co-payment.
Before going to hospital, talk to your specialist and insurer about your fees and costs. See Guide to costs for more information. You can also look up your policy at privatehealth.gov.au(opens in new tab)
Included
- Specialist fees
Excluded
- Assistant surgeon fees
- Anaesthetist fees
- Hospital fees
Your private health insurer may be able to cover part, or all of these fees, depending on your level of insurance. Talk to them and your specialist about the cost implications.