I Had a Gastric Bypas 6 Yrs Ago and Had About 5 Umbilical Hernias, and I Now Have Another. Will Insurance Cover?

asked 4 months ago by Lakin
Latest answer by Steven Turkeltaub, MD
Question viewed 63 times
Tags: coverage, hernia repair, insurance, multiple

I've had gastric bypass surgery 6 yrs ago and had umbilical hernia's since now I'm having surgery again. Since I have so much scar tissue from all these surgerys can my surgeon do a tummy tuck ( a mini one or full) with it being medically nessascary? Since the bypass I've had so many problems with scar tissue in my belly and hernia's. Is it possible my dr and the INS co will ok this? Thanks for your help.

6 answers to I Had a Gastric Bypas 6 Yrs Ago and Had About 5 Umbilical Hernias, and I Now Have Another. Will Insurance Cover?

Insurance coverage for a tummy tuck with complex medical history extremely unlikely

It is very unlikely that your insurance company will pay for a tummy tuck despite your medical history. You can attempt to submit the information but don't expect a positive answer.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon

www.turkeltaub.com

Tummy tuck and Insurance Coverage?

Although not possible to know until you check with your insurance company, I doubt that the tummy tuck surgery will be covered. On rare occasions, panniculectomy surgery is covered. However, umbilical hernia repair is generally a covered benefit. Best wishes. see video

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Insurance coverage

It is unlikely that your insurance will pay for a tummy tuck. They may cover the umbilical hernia repair though. Donald R. Nunn MD Atlanta Plastic Surgeon.

Donald Nunn, MD, DDS
Atlanta Plastic Surgeon

A tummy tuck is not a medically necessary procedure

You will need to check with your insurance company to see what is a covered benefit for you under your plan. Typically, insurance companies will pay for hernia repairs as medically necessary but a tummy tuck is cosmetic and is not covered. Sometimes, a panniculectomy is covered. See your surgeon to discuss this in further detail to see what you are a candidate for. I hope this helps.

J. Jason Wendel, MD
Nashville Plastic Surgeon

Check with your insurance

Recently I have seen that nearly all of the Bariatric procedures can be done with endoscopic techniques. This has resulted in less of an abdominal wall problem and fewer hernias to deal with. I have treated a number of patients with problems like yours. It is often easier to get hernias covered if done by your general surgeon. The insurance likely will only pay for panniculectomy which in itself is inadequate in most post Bariatric patients and then only... more

Thomas R. Walek, MD
Providence Plastic Surgeon

Insurance coverage for tummy tuck

The short answer is it depends. And it depends on a lot of things including your individual insurance policy as well as how much weight you have lost and whether there are medical reasons for the tummy tuck such as rashes or infections. Insurance is more likely to cover removal of excess skin after significant weight loss, a procedure called a panniculectomy, rather than the procedure called an abdominoplasty which usually involves repositioning the belly button and which is usually... more

Margaret Skiles, MD
Sacramento Plastic Surgeon

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