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Infected C-section Scar Covered By Insurance?

I had a total of 3 csections, the last one I ended up with a deep sunken scar that is itrtiated and infected all the time. My stomach sticks out and skin hangs over the scar causing even more issues. Wouldn't this be covered by insurance?

Doctor Answers (7)

Covered by insurance?

+1

Probably not. Insurances will provide coverage for procedures that are done in order to improve function. Although we don't have pictures to judge, it sounds like you have a poorly healing scar with some abdominal skin overhang. One might argue to the insurance company that the poorly healed scar " is not normal" and a revision should be covered. They will probably consider it "cosmetic" since there is no functional deficit involved. I believe that the same is true with the excess abdominal skin as well.

You can always contact your insurance company so that they can make a direct determination....but more often that not - the procedure will not be covered.


New York Plastic Surgeon
5.0 out of 5 stars 6 reviews

Insurance coverage for scar revision

+1

Health insurance coverage for elective procedures will need to be pre authorized in writing by a physician.Insurance companies have become very difficult to work with and will not OK a tummy tuck for this type of problem, but may OK a scar revision if you can prove chronic infections. A scar revision would consist of removing the depressed scar and "re-arranging" the surrounding skin to prevent further problems. This should be a quick outpatient procedure with a rapid recovery.

David Finkle, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 45 reviews

Insurance for c-section scar

+1

My experience has been that most folks need a tummy tuck in your situation. Its possible that your insurance may cover a small portion of the fees for the scar revision. Without an examination its impossible to give much useful advice besides that I would find a PS on your insurance plan and visit with them.

Mahlon Kerr, MD, FACS
Austin Plastic Surgeon
5.0 out of 5 stars 68 reviews

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Infected C-section Scar Covered By Insurance?

+1

The answer depends entirely on how your contract with your insurance carrier is written. There is no way for us to know on this website. You might want to get a consultation and exam and then the doctor can ask your carrier if his planned surgery is covered.

Ronald V. DeMars, MD
Portland Plastic Surgeon
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Infected C-section Scar Covered By Insurance?

+1

A scar revision might well be a covered procedure given the info in this posting. What would not likely be covered is an abdominoplasty to treat the protruding abdomen or the overhanging skin.

All the best.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
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Baltimore scar revision and insurance coverage

+1

It's hard to say without seeing you and sending in photos to your insurance company. However, it sounds like this is something that can get covered if you're having chronic infections.

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 66 reviews

Infected C-section Scar Covered By Insurance?

+1

If you can get your doctor to document the infections, it is likely that insurance may cover the scar revision.

Karol A. Gutowski, MD, FACS
Columbus Plastic Surgeon
5.0 out of 5 stars 17 reviews

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.