Is Diastasis Recti Repair Covered by Insurance?

I have 2 children, both via C-section. I have a 3-4 finger width separation between abdominal muscles. It is very uncomfortable, especially after i eat. It also is painful when I cough, or sneeze. I really would like to have repaired, but I am concerned it will be all out of pocket and insurance will not cover it. Can you please give me some insight?

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12 Doctor Answers | Asked by Tricia in PA

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Is #DiastasisRecti Repair Covered by Insurance? ANS:

Most insurance companies will not pay for this repair. As stated, it would really have to be more of a hernia than a weakness....And even if they did pay, they are getting very savvy nowadays and would probably only pay for part of the surgery...

Rectus Diastasis Repair

Rectus diastasis repairs are deemed not medically necessary by insurance companies. Hence, it is consider a cosmetic self-pay procedure.

Diastasis recti

Only hernia repair is covered by insurance. Diastasis is a general relaxation of the muscles and tissues around it. this not covered by insurance. The reason hernias are covered is that a piece of bowel can be caught in it, and if the tissues swell and the circulation of the bowwel is geopardised then a big problem would occur. This would not happen with diastasis recti.

Is Diastasis Recti Repair Covered by Insurance?

Tricia It would be most unusual today for a diastasis repair to be covered by insurance. It is widely considered a cosmetic procedure without medical indications. and without evidence that treatment has anything but cosmetic benefits. Hernias on the other hand have health risks and their repair has clear medical benefits, and those operations are covered by most policies. If a tummy tuck is done at the same time, ti will not be covered. (I have seen patient bills where their... more

Diastasis Recti Repair is a cosmetic procedure.

Diastasis Recti repair is not recognized as a "medically necessary procedure" by insurance carriers. It is a procedure that is performed as part of a larger operation called an abdominoplasty (tummy tuck), which is cosmetic and is paid for by the patient..

Diastasis is usually not covered by insurance

The only thing that I would add to the excellent responses from the other plastic surgeons listed here is that even if the diastasis or hernia repair was to be covered, the rest of the abdominoplasty would not be covered. Patients often believe that if the hernia or diastasis is covered then the facility and anesthesia fees will be covered so that the abdominoplasty will cost less. Insurance companies look at the anesthesia and OR nurses records to see what time the cosmetic... more

Diastasis Recti Is Not Usually Covered By Insurance

Dear Tricia in PA, Unfortunately, even symptomatic diastasis is not covered by insurance. However, if you have a hernia, you may be able to get coverage for this problem. I would suggest a consultation with a general surgeon to determine if you have a hernia. If not, most plastic surgeons repair the diastasis at the time of a tummy tuck. This would be an out of pocket expense however. Good luck.

Diastasis repair is not usually covered by insurance, but make sure it's not a hernia!

Thanks for your question. Unfortunately, diastasis recti is not covered by insurance even if it causes pain, swelling, bloating, deformities, back pain, etc. More studies need to be done to prove the benefit of repairing the separation of the muscles. However, from your symptoms it sounds like you may have a hernia. A hernia repair is covered by insurance, so have your plastic surgeon or general surgeon examine you to determine whether or not you have a... more

Rectus Diastasis Repair Rarely Covered by Insurance

In the past, I had occasional cases where a patient with significant symptoms had insurance coverage of a rectus diastasis repair (but not a complete abdominoplasty). However, this is much less common now. You and your primary care physician may want to start documenting your symptoms and then ask your insurance company if they would consider covering it if your symptoms do not improve. You may be asked to try physical therapy first.

Any aesthetic surgery is covered for any cy. excepts by traumatic accident and in europe the reductive mastoplasty is covered

I think it wont be covered, so please programe it for TT and herniae correction plus lyposuction

Insurance and Abdominoplasty

Most insurance companies do not cover this procedure as they consider it cosmetic. Insurance companies are becoming more and more strict on what procedures they cover and whether or not it is a medical necessity. More than likely this will be something that you will have to pay out of pocket for.

Diastais of the rectus muscle is not a medical problem.

Insurance companies and HMO's will not cover the surgery to fix a diastasis of the rectus muscles. Make sure you are examined and you do not have a hernia because this is a different issue. In the mean time you can tone your abdominal muscles and this might help with your symptoms. Best Wishes Dr. Peterson