Insurance coverage for abdominoplasty

Robin T.W. Yuan, 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.


Robin T.W. Yuan, MD
29 days ago

Insurance companies have various criteria for deeming your condition severe enough and the surgery medically necessary. Obvious signs are frequent rashes requiring treatment, ulcerations of the skin, and infections (cellulitis) caused by open sores. It sounds as if this surgeon is not interested in doing the procedure recommended under an insurance plan. I would contact your insurance plan and check their criteria. Sometimes this is published on the internet. Consult with other plastic surgeons who might be more sympathetic to your needs. You might be approved for a panniculectomy but not a full abdominoplasty so if some of your goals are cosmetic, you might have to work the combination out with your surgeon.

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