Doctor talking to elderly patient

Heart valve replacement

Get an overview of the out-of-pocket costs associated with your procedure so you know what to expect.

What is heart valve replacement?

Heart valve replacement is a surgery that treats heart valve disease by replacing the diseased heart valve with a mechanical valve or one made from cow, pig or human heart tissue (biological tissue valve).1 It is performed in hospital, under general anaesthetic (you’ll be asleep), and is used to treat serious cases.1

Heart valve disease impairs the heart’s function which can cause chest pain, shortness of breath, and other symptoms.1

After surgery, your breathing should be improved and you should have less chest pain, more energy, and a better quality of life.1

Heart valve replacement is performed by a cardiothoracic surgeon.

There are several different heart valve replacement surgeries, with different medical terms such as aortic valve replacement and mitral valve replacement.

How much does heart valve replacement cost?

Our out-of-pocket calculator will provide you with a clear understanding of the typical costs associated with this common hospital procedure.

It’s important to understand how getting your procedure in a public or private hospital differs.

QuestionPublic system 
(Without health insurance)
Private system 
(With health insurance)
Will I avoid public hospital waiting lists?

No.

Yes.

Will I be able to choose my hospital?

No.

Yes.

Will I be able to choose my doctor or surgeon?

No.

Yes.

Will I have out-of-pocket costs?

No.

Yes.

In a public hospital, heart valve replacement is covered by Medicare for eligible residents.

Once you are discharged from hospital, you may still need to pay out-of-pocket for things like medicines and health services (like physiotherapy or occupational therapy).

In a private hospital, private health insurance can cover some costs of heart valve replacement.

You may have an out-of-pocket cost if you use private hospital cover when you get treatment. You can minimise some of these costs by choosing a hospital and specialist that have agreements with your health insurer.

If you have an excess on your cover, you will have to pay for that out of pocket.

Hospital excess is the amount of money you contribute upfront (out of your own pocket) before you can claim a benefit on hospital treatment. With HBF hospital cover, you choose an excess option when you first get hospital cover, but you can change your excess at any time.

With HBF, you only pay hospital excess once per person, per calendar year (to a maximum of twice on a family policy) when you’re admitted to hospital.

Are you an HBF member? You can check your excess in myHBF or the HBF App. This is the set amount you’ll pay when you’re admitted.

A hospital out-of-pocket cost is the portion of a hospital bill that you pay from your own pocket for which you won’t be reimbursed – by either health insurance or Medicare.

If you want private health insurance cover for heart valve replacement, look for HBF hospital cover (not extras cover) that includes a category called ‘Heart and vascular system’.

You need to hold hospital cover that includes ‘Heart and vascular system’ for two months before you can claim for a heart valve replacement (or 12 months if you need a heart valve replacement due to a pre-existing condition).

Find hospital cover for heart valve replacement

Ask your GP for an open referral

Your GP is the one who’ll most likely refer you to a specialist – but you may want the option to choose your own specialist.

Asking for an open referral can let you:

Older man holding chest

Signs you might have heart valve disease

Heart valve disease can cause mild to severe symptoms including:1

Doctor looking at X-ray

Diagnosing heart valve disease

If you think you may have heart valve disease, see a doctor. There are a number of diagnostic tests they can use:1

Woman smiling with a pill

Alternatives to heart valve replacement

There may be alternatives to heart valve replacement, depending on your condition:1

Woman making a heart symbol with her hands

Heart valve replacement recovery

Heart valve replacement surgery is an intensive procedure, and full recovery takes several weeks to months.2, 3

Looking for health insurance? Get a quote in minutes

Compare our hospital and extras cover options now. Or use our recommendation tool to select your needs and find our most affordable cover to suit.

Compare HBF cover
Woman on laptop smiling

Further reading

Doctor with notebook
Understand your hospital cover and reduce stress during your stay with our simple hospital guide.
Learn more
Woman having a cup of tea with laptop
Already an HBF member? See what you’re covered for and manage your cover by logging into myHBF.
Learn more
Women running together
See if one of HBF’s support programs could help you get healthy or stay healthy.
Learn more

1 Heart Foundation - Heart Valve Disease (2023)

2 Health Direct - Mitral Valve Surgery (2023)

3 St. Vincent’s Hospital - Heart Valve Surgery (2021)