On What Grounds, Can a Tummy Tuck and a Male Breast Reduction Be Classified As Medical Procedures?

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7 Doctor Answers | Asked by Ihaveaproblem in Singapore

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Different criteria for different insurance carriers

There is a high degree of variability amongst insurance carriers. I have seen young maies with severe gyencomastia covered and abdomens with heavy pannuses covered. Best to contact your carrier with a good letter detailing your medical issues and a supporting set of standardized photos illustrating your problems.

Insurance for gynecomastia and tummy tuck

Until about 10 years ago, insurers would consider payment for gynecomastia surgery. They have implemented more restrictive guidelines and the only basis for coverage would be genetic markers establishing high risk for breast cancer. The code for the surgery is mastectomy for gynecomastia. Barring this, the surgery, whether resection of glandular tissue or liposuction, would be considered cosmetic. Tummy tuck is also subject to more restrictions. A ventral hernia... more

Insurance rarely pays for gynecomastia correction and tummy tucks

If you're inquiring as to how you can get your gynecomastia correction and tummy tuck covered by insurance, this is very difficult to do. Your gynecomastia would have to be from a tumor or trauma as well as the excess skin of your abdomen.

Insurence and gynecomastia surgery

The best way to find a ground for possible,but not likely, insurance coverage is to go to the official "American society of plastic surgeons" web site. Ask them for "position papers about gynecomastia surgery".Those papers will clarify when one may be eligible for insurance coverage. wikipedia gynecomastia may also give you same clues. see video

Male breast reductions and tummy tucks--medically necessary?

Usually, male tummy tucks and breast reductions are cosmetic procedures that are not covered by insurance, including when performed after weight loss. If there were severe skin rashes underneath an apron of excess abdominal skin (called a pannus), insurance might cover the excision of the excess skin, but not an entire tummy tuck. Regarding the breast reduction, in my experience the only time this has been covered is in young male patients with a painful localized mass of breast... more

Are tummy tucks and male breasts reduction medically necessary?

Generally tummy tucks and male breast reductions are not medically necessary. Some insurances will cover a tummy tuck in a massive weight loss patient who has lost over 100 pounds and has rash and yeast type of infections under the abdominal skin folds. I have never seen male breast reductions covered as medically necessary.

Tummy Tuck and Male Breast Reduction as Medical Procedures

Both Tummy Tuck and Male Breast Reduction are typically cosmetic (not medically necessary) procedures. These procedures may become medically indicated (either necessary, recommended, or medically appropriate) when: There is significant pain that may be improved, such as with a large hanging area of excess skin A hernia or severe loss of support of the abdominal muscles is present Excess skin is causing problems with rashes, irritation or infection (or perhaps... more