Abdominoplasty is not covered by insurance companies

Sam Jejurikar, MD answers: How to convince insurance company to cover tummy tuck?

I went to see about a tummy tuck and the doctor said I was a good candidate to have it done. As soon as she heard of my insurance, she said no they do not cover that. With me having hip pain, back pain, unable to do many exercises from excess skin, how does a doctor let my insurance company know it is not just cosmetic. She did not even try to help me get my insurance company to do the surgery. I would like some help in this area.


Sam Jejurikar, MD
28 days ago

Hi,

Although most patients don't like it, abdominoplasty is considered a cosmetic surgery procedure and, as such, is not covered by insurance companies.  The only operation that insurance companies will consider covering is a panniculectomy, in which a wedge resection of the lower abdominal skin is performed; the abdominal wall is not tightened, the skin is not lifted off the abdominal wall, and the belly button is not relocated. Insurance companies will usually only covering that procedure if patients have problems with skin breakdown, rashes, or difficulty walking due to the amount of the overhanging skin.  It is no way a cosmetic procedure and the results are not comparable to abdominoplasty.  If you have documentation of the above-mentioned problems, you may be a candidate for a panniculectomy.

Hope this helps.  Best of luck.

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