Will Insurance Cover Removal of Extra Skin?
- Asked by atgall01 in las vegas nv
- 4 years ago
I am 51 years old and used to weigh 280 lbs. Six years ago, I lost all the weight; now I weigh 100 lbs. i had 2 c-sections, a tubual ligation through another incision and total hysterectomy through another. The incision caused a lot of pain and I have hanging loose skin. It is not terrible but I get yeast infections, sores and have trouble emptying my bladder without pushing on my stomach. My GP has recommended that I see to have the extra skin removed. Is this something that insurance may cover?
Panniculectomy vs Tummy Tuck
I have recently discussed this on my websites journal section. You may be a candidate for panniculectomy which involves removal of the skin. This is the procedure that insurance may cover. They will not cover an abdominoplasty procedure which is removal of the skin and tightening of the abdominal muscles.
Your plastic surgeon would need to take pictures and submit a predetermination letter on your behalf to basically ask the insurance company if they would cover the panniculectomy procedure.
Web reference: http://www.feplasticsurgery.com/
Will insurance cover removal of tummy extra skin overhang?
The procedure you are inquiring about is called a PANNICULECTOMY and involves the removal of only the skin overhang. It is NOT an Abdominoplasty (tummy tuck) which is a cosmetic procedure in which not only is any loose tummy skin removed but the abdominal muscles are tightened from the pubis to where the ribs meet in the midline and the belly button is translocated to allow skin removal. The latter operation is NEVER paid for by insurance companies.
The best strategy is look in your insurance benefits book if your policy even covers it. If it does, your insurer SHOULD have a list of plastic surgeon who accept your policy.
Copy that list and review it against their listings at www.Plasticsurgery.org - The American Society of Plastic Surgeons members listing and you will be able to choose which one of them to see.
Peter A Aldea, MD, FACS
Panniculectomy and insurance
Insurance coverage for a panniculectomy may be possible. It depends upon your insurance company and your documentation. Also, some doctors do not accept insurance and so you many have to pay out of pocket for this procedure.
Insurance coverage for panniculectomy
With your history, it is possiblethat you might get smoe insurance coverage depending on your insurance plan. They look for things like yeast or bacterial infections, dermatitis, ulcers, etc. These indicate a medical necessity for removal of the hanging skin. Whehter they will pay only for a panniculectomy or a full abdominoplasty is debatable. Evidence of abdominal hernia would strengthen your position.
Insurance coverage of massive weight loss
This will vary according to your insurance program. It is best for you to select a surgeon first and then ask them to submit a predetermination of benefits letter to your insurance carrier. They will then be more likely to approve your procedure.
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.