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Would Having a Ventral and an Inguinal Hernia Repaired Convince Ins Co to Cover Diastasis Repair? (photo)

Had 5 preg., ventral hernia repair after 2nd & 2 inguinal hernias side by side repaired yesterday. OB said fist fits between my diastasis recti muscles. Have back pain when folding laundry, washing dishes, & bathing kids. Spoke to gen surgeon of repairing this, but he said ins will say no. Is there a remote poss. ins could help pay for DR repair, given my history, when I have a TT? Read all no answers, but wasn't sure if my hist. provides complications that could deem repair poss. necessary.

Doctor Answers (7)

Insurance coverage of Tummy Tuck

+1

Since a diastasis is not a hernia, insurance will not cover the repair.  Remember, they are in the business of taking your money, not giving it away!!!  The DR repair is part of a tummy tuck and not an extra charge- the TT is what you need anyway.  With all you've been through, you deserve it!

Hilton Head Island Plastic Surgeon
5.0 out of 5 stars 14 reviews

Diastasis would be repaired at the time of the ventral hernia correction.

+1

If insurance covers a ventral hernia, and it probably should, repair of a diastasis would be a component of that operation.

Web reference: http://www.zubowicz.com/subpag,21-atlanta-abdominoplast.htm

Atlanta Plastic Surgeon
4.5 out of 5 stars 6 reviews

Insurance Coverage of Diastasis Recti Repair

+1

This is very rarely covered by insurance but is included in a standard tummy tuck. You should discuss with your plastic surgeon. 

Columbus Plastic Surgeon
5.0 out of 5 stars 16 reviews

Would Having a Ventral and an Inguinal Hernia Repaired Convince Ins Co to Cover Diastasis Repair?

+1

The best advise is "forget about this!!!" Just pay for the repair with the TT and get on with your life. 

Miami Plastic Surgeon
4.5 out of 5 stars 55 reviews

Diastasis Repair Covered by Insurance?

+1

Dear FF, 

Thank you for your post.  I would also be very suprised to find an insurance company to cover diastasis repair since this is not a true hernia.  However, most plastic surgeons will repair this at the time of abdominoplasty /(TT) at no additional cost. 

Best wishes,

Pablo Prichard, MD

Web reference: http://www.aaaplasticsurgery.com/photo-gallery/details.cfm?ID=79&StartRow=16

Phoenix Plastic Surgeon
5.0 out of 5 stars 22 reviews

Ventral hernia not generally considered medically necessary surgery

+1

It is very unusual for a an insurance company to consider repair of a ventral hernia or diastasis recti after pregnancy as medical necessary.  This does not mean that you don't have a real physical problem that can be corrected surgical and will generally improve your posture and back pain.  

Atlanta Plastic Surgeon
5.0 out of 5 stars 7 reviews

Would Having a Ventral and an Inguinal Hernia Repaired Convince Ins Co to Cover Diastasis Repair?

+1

I would be quite surprised. Insurers hold, correctly by most evidence, that the diastasis is not a functional problem, but a cosmetic one. 

Your tummy tuck should include abdominal wall tightening in the fee structure anyway. 

All the best. 

Seattle Plastic Surgeon
4.5 out of 5 stars 28 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.

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