Diastasis/Hernia and TT. Can Insurance Help? (photo)

I've lost 40 pounds this year and discovered my ab muscles appear to be deformed. A GS told me I have an umbilical and ventral hernia as well as diastasis. He says stop exercising! He wants to repair hernias with a vertical incision from sternum to BB. He will not fix diastasis. I have some loose skin from pregnancy so am considering a TT as well. PS I have contacted do not deal with insurance. How can I get insurance to cover at least hernia repair? Should I really stop working out?

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7 Doctor Answers | Asked by innerautumn

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Abdominoplasty with Mesh Reinforcement

You are an excellent candidate for Abdominoplasty with Mesh Reinforcement to restore your abdominal wall. There are recently published articles in Plastic and Reconstructive Journal describing this technique. The advantages of this technique is it is done through a low transverse incision, not the vertical incision that a GS would use. Large mesh is used to reinforce the abdominal wall and is sutured laterally to give a more hourglass figure and more stable fixation. ... more

Hernia repair with tummy tuck

Insurance companies very seldom pay for a diastasis repair but might pay a little bit if you do actually have a true hernia. Any way you go about it, you will never win with the insurance company if you have a tummy tuck done. The insurance companies are wise to this after dealing with it for many years.

Diastasis/Hernia and TT. Can Insurance Help

The hernias and diastasis repairs can readily be fixed through a tummy tuck incision, which is much less noticeable than a vertical incision would be. Typically the insurer will pay for the hernia repairs, but not for the tummy tuck, though the tummy tuck typically includes a diastasis repair. One possibility is to pay out of pocket for the TT which could be done at the same setting as the hernia repair. Another is contacting your insurer for a plastic surgeon who is in their... more

Hernia repairs with tummy tucks

Are done frequently. As mentioned, most plastic surgeons have experience in repairing ventral and umbilical hernias. Mixing insurance and cosmetic procedures can be tricky. If you are dead set on trying to get insurance to cover some of your procedure, I would suggest getting a general surgeon or qualified plastic surgeon that accepts insurance and coordinate procedures. In my neck of the woods, if someone scheduled a tummy tuck with me and am willing to give up their... more

Curtis Wong, MD

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Redding Plastic Surgeon

Hernia and abdominoplasty.

You appear to be a wonderful candidate for the combined procedure. Hiding the scar in a low horizontal location is far better cosmetically than a long vertical scar proposed by your GS and accomplishes the reconstructive hernia repair and cosmetic abdominoplasty.. Most Board Certified PS have experience in both and typically private practice surgeons have much more cosmetic experience. Do your research and find a Plastic Surgeon with whom you feel comfortable and has good references and... more

Insurance for hernias

Speak to your insurance company and ask them what plastic surgeon works with their network in your area. Often the university hospitals have surgeons participating with more companies than the docs in private practice. Good luck!

Insurance should cover hernia, maybe abdominoplasty.

I treat patients like you often. An abdominoplasty approach to your hernia and diastasis repair. As both a board certified plastic surgeon and board certified general surgeon, I perform these procedures with insurance preaproval.