Can I use health insurance for hernia surgery? 

Waiting for hernia surgery can be a long, and potentially painful, process. The latest data from the Australian Institute of Health and Welfare shows that the median wait time for hernia surgery was 77 days (around 2.5 months). But that’s only an average – around 6% of people waited more than a year for their surgery. With waits like these in the public system, you might be wondering whether it’s worth going to a private hospital. Here’s everything you need to know about using health insurance for hernia surgery. 

What is hernia surgery? 

Hernia repair surgery, also called herniorrhaphy or hernioplasty, is one of the most common elective surgeries in Australia, with around 90,000 performed each year. A University of South Australia study found around 89.6% of the hernia repair surgeries in Australia between 2017 to 2021 were performed on men. An inguinal hernia repair (the most common type) is a day surgery where a surgeon will remove the hernial sac through your groin. 

Is hernia surgery covered by health insurance?  

Yes, hernia repair surgery is covered by health insurance. It falls under the Hernia and Appendix clinical category of Hospital Cover, and is included on all policies at Bronze tier or higher. Using the healthslips.com.au calculator, we found many Basic Plus policies also included unrestricted cover for hernia surgery.  

What do the tiers of Hospital Cover mean?   

To claim hernia repair surgery on health insurance, you’ll need to have served your waiting period and be up-to-date with your premiums. Depending on your policy and the surgeon, you may have to pay an excess, co-payment and out-of-pocket costs.   

What’s the Gap for hernia surgery? 

According to the government’s Medical Costs Finder website, the average Gap for an inguinal hernia repair for a private patient is $500.  

Why do I have to pay a Gap? 

To reduce your Gap for hernia surgery, you can phone other surgeons to see what they charge for the same procedure, and ask whether they have a no-Gap or known-Gap arrangement with your insurer. It’s also worth checking whether the hospital is an Agreement Hospital with your insurer, which means you won’t have to pay a Hospital Gap.  

What’s the best health insurance for hernia surgery? 

The best health insurance for hernia surgery is one that offers the level of cover you need for a price that fits your budget. As of December 2025, the cheapest health insurance for hernia surgery we found for one adult in Victoria using the healthslips.com.au calculator was a Basic Plus policy for $110.24 per month, with a $750 excess.   

How do I find the best health insurance for hernia surgery? 

To find the best health insurance for hernia surgery, use the healthslips.com.au calculator to search every policy in Australia in mere minutes, for free. With no commercial bias and open access, you can trust you’re getting accurate results and can be anonymous. Look for a new policy or compare your existing policy to see if you can find a better policy for your needs.  

healthslips.com.au does not provide general or personalised advice. Your particular circumstances are likely to impact the accuracy, completeness and relevance of the information or results. Take this into account before making a decision and talk to an expert for financial advice.  

Trudie McConnochie

Writer and Researcher

Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.

Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.

Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.

Read more.