Tummy Tuck: Q&A

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What to Do for Insurance Coverage for Tummy Tuck and Breast Reduction?

I have spreaded since I had my daughter 3 years ago. I am a size D and my breasts get in the way. I also need a tummy tuck because my fat on my stomach gets stuck in the zipper of my pants. I have Amerigroup Medicaid insurance and I live in Maryland. I called to ask if they cover tummy tuck and breast reduction, and they said that it isn't. I have no hope but to cut it myself because I am so depressed. Ever since I had her my self-esteem went down..I need help, these surgeries will make me feel so much better. Any idea on how I can get these procedures covered?

8 Doctor Answers | Asked by Kim20099 in District Heights Md
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Insurance will not cover cosmetic breast and tummy tuck procedures

Insurance companies will for practical purposes not cover tummy tuck surgery for "fat getting caught in a zipper" but rather will insist on you losing weight, have recurrent infection or other functional problems. Re: Your Breasts -Unless 400-500 grams are being removed from at the time of your breast reduction - doubtful for a D cup size, and you have severe documented symptoms from large breasts you will not be covered. Here is some more information about... more
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Insurance coverage for breast reduction and tummy tuck

Many insurances will not cover a D cup reduction. Others require documentation of conservative medical management including physical therapy. Abdominoplasty is generally not covered without documented medical reasons to support the request. Psychiatric distress has not been grounds for insurance coverage for many years.
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Insurance coverage for breast reduction.

80% of breast reduction questions on RealSelf are about insurance coverage. Here are some helpful points. 1) Insurance companies try very hard not to pay for breast reduction, even though they should. Even small breast reductions relieve many symptoms such as back pain and shoulder pain, and even some types of headaches. 2) Very big reductions (like from an F cup to a C cup) will usually be covered. 3) Many policies will pay for breast reduction if 500 grams (a little more than a pound)... more

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No insurance for cosmetic surgery

As you have learned, there is no insurance, nor should there be, for cosmetic surgery. Insurance money needs to go toward covering medically necessary care. Please consider going to Johns Hopkins in Baltimore and see if they have a "plastic surgery resident's clinic" where you can have cosmetic surgery at dramatically reduced prices. Good luck!
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Medicaid will NOT pay for Cosmetic Surgery

Medicaid IS NOT insurance, as we know it. It is a small selection of ESSENTIAL to your health, hard to obtain, poorly paying medical services which looks like will get worse because of the poor economy and the States' tax money shortage. A Tummy Tuck (Abdominoplasty) is an extensive cosmetic surgery which involves relocation the belly button, tightening the tummy muscles and removing loose skin. It is never paid for by real insurance company, much less so by Medicaid. In rare cases, some... more
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Insurance will pay for some operations

Kim, Many insurance plans will pay for certain operations for body contouring when medically necessary, such as: 1) BREAST REDUCTION 2) PANNICULECTOMY (removal of excess abdominal skin) 3) HERNIA REPAIR Most PPO, and POS plans and even Medicare will cover some of these operations. However, every insurance company has different requirements before they will cover them. You should check with your insurance company and even consider upgrading to a different insurance company or insurance plan.... more
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Insurance for tummy tuck and breast reduction

Dear Kim These are questions I am asked frequently. Unfortunately the answer I will give you will not make you happy. As far as breast reduction goes you need to show several things. First you have tried non-surgical methods to control your symptoms. And you must have documented symptoms of back pain, neck pain bra strap grooving and intertrigo as documented by your primary care doctor or chiropractor. Then you must be within a "normal weight for your height and finally depending... more
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Tummy tuck

As already mentioned, insurance will not cover cosmetic procedures.  As with anything, if you feel that it will help you, I suggest saving up and paying for the procedure.  It may sound expensive (and it may be) but it will have a great beneficial effect on a person.   The rewards are great.
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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