Ask a doctor

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 13 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.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 7 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. 

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

You might also like...

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. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 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

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 24 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.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 8 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. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 30 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.