I have public aid for insurance. Do doctors take that for tummy tuck procedures or will I have to pay for it out of pocket?
What Type of Insurance Do Most Doctors Take for Tummy Tuck?
Doctor Answers (10)
Insurance NEVER Pays for Tummy Tuck
I think that you are confusing 2 separate procedures:
A panniculectomy is a functional procedure for removing excess skin and fat. An insurance company MAY authorize a panniculectomy if...
- The apron of excess abdominal skin impedes walking.
- The apron of excess abdominal skin impedes normal groin hygiene.
- There are recalcitrant fungal infections beneath the skin folds.
- The infections have progressed to bacterial infections, necessitating hospitalization and IV antibiotics.
A panniculectomy is NOT an attractive operation. The goal is function, not cosmesis.
- There is no tailoring of the skin excess.
- There is no liposuction to contour the flanks.
- The bellybutton is not preserved.
- The muscles are not tightened.
- The abdomen is not optimally flattened.
If your goals are functional, then you should consider a panniculectomy. Find a Board Certified Plastic Surgeon who accepts your insurance, and then speak with him/her frankly.
If, however, your goals are too have a more attractive torso, then you are looking for an abdominoplasty, better known as a tummy tuck. Obviously, no insurance company is going to pay for you to look cuter; that's your financial responsibility.
It is hard to quote a exact price for any particular surgery because of all the different variables such as particular surgeons fees and operating room and anesthesia cost very immensely.
Tummy Tuck and Insurance
Tummy tuck is a cosmetic case and insurance company does not cover cosmetic procedures. It would have to be cash.
The only procedure that insurance would cover would be a panniculectomy and it is again a very difficult procedure to get insurance to cover.
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Tummy tucks are not covered by insurance
Since a tummy tuck is a purely cosmetic procedure, it will not be covered by insurance. Only a panniculectomy is sometimes covered by the insurance company.
Tummy tuck by insurance is not likely
While tummy tucks are not typically covered by insurance (they sometimes don't cover actual illnesses, much less cosmetic concerns) they may pay for a panniculectomy in certain cases. The difference is a panniculectomy entails removal of excess, hanging skin, but without the movement of the belly button, muscle/fascial tightening, liposuction, etc. In the past there was confusion over whether insurance may cover a tummy tuck due to CPT (billing) code discrepancies, but those CPT issues are cleared up now.
Tummy tuck and insurance
Tummy tucks are not covered by insurance. They are cosmetic procedures that are designed to make you look better and fit into clothing better.
Hernia repairs, panniculectomy are often covered by insurcance and may be part of a tummy tuck but if there is a cosmetic nature to the procedure it is not covered.
Medical insurance for a tummy tuck
Unles your doctor can convince the insurance that there is some "medically necessary" reason for you to have a tummy tuck, it will not be covered by insurance. I think you would be wise to plan on the insurance not being willing to cover it.
Insurance for Tummy Tuck
Insurance policies will only very rarely pay for a tummy tuck; usually only if there have been repeated infections which require expensive antibiotics or antifungals to treat. Your Medicaid insurance would probably have even more stringent requirements and is extremely unlikely to civer a TT.
Medical insurance does not pay for tummy tuck
I regret that you are in financial dire straits. But almost no one takes insurance for anything. When you purchase something, it is up to you to pay for it. Lawyers do not take insurance. Plumbers and Electricians do not take insurance. The vast majority of our service sector does not take insurance for anything.
To make things even more confusing medical insurance companies are actually LOSING money (despite raising premiums and lowering doctor fees every year). Don't believe it ? - Read - http://apnews.myway.com/article/20091025/D9BI4D6O1.html. They have gradually narrowed what they pay for AND they pay less for those procedures and services. Insurance companies NEVER paid for cosmetic surgery (tummy tuck, breast lift, liposuction etc) and they never will.
Do plastic surgeons accept public aid for tummy tuck?
Most insurance companies do not cover abdominoplasty as it is an elective procedure. For patients with limited funds, one option is to contact a local teaching hospital that has a plastic surgery training program. Often these programs have clinics, run by the residents and supervised by the attendings. Patients can sometimes have elective surgery done through these clinics for a lower fee than a private plastic surgeon would charge. Hope this helps.
Tracy M. Pfeifer,MD, MS
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.