Is a Tummy Tuck Ever Considered Medical?

I have had overlying skin on my lower abs since I was quite young due to the loss of weight. I then had two c-sections, hysterecotomy and the fat just increased. I now have lumbar lordosis, spinal stenosis and degenerative disc disease. Also asteoarthritis and fibromyalgia. Is a tummy tuck ever considered medical?

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6 Doctor Answers | Asked by CAgirl65 in wilmington, NC

Doctor Answers (6)
Community Comments (1)

Insurance coverage for abdominoplasty

Thanks for the question - In our San Francisco practice we've done a fair number of abdominoplasties. It is unusual for companies to cover a true abdominoplasty. Many insurers will cover massive weight loss patients for panniculectomies (removing the abdominal pannus). The theory here being that patients with skin down to their knees have significant mobility and hygiene problems. We have had insurance companies cover abdominoplasty for significant abdominal scars but it is a rarity. I... more

No, but it might help you very much

It sounds as though a tummy tuck might be very valuable and make your abdomen much better. The muscle tightening might help your back a little bit. You have enough anatomical problems in your back plus other conditions that you might not feel much different though. Don't expect that insurance will cover any of this.

Tummy tucks and insurance

A tummy tuck is almost never covered by insurance. Insurance companies sometimes cover a panniculectomy for massive weight loss patients.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Tummy tucks are rarely considered medically necessary

Tummy tucks are a popular and effective way to recontour the abdomen. They may be commonly combined with other procedures that are considered medically necessary such as gynecologic surgery or hernia repairs. By themselves, however, tummy tucks are not medically necessary. If you have an excess amount of skin in your abdomen and our experiencing pain or rashes from this skin, you may benefit from a panniculectomy. This is an excision of the skin without a deeper muscle repair. To... more

Medical necessity letter for Tummy Tuck

It is very hard to get insurance approval for an abdominoplasty. However, I would recommend that you try with your insurance company. Your letter to them must be supported with all the medical reports indicating the medical need for a tummy tuck.

Tummy Tuck and Insurance

There are many procedures that, while covered in the past, are no longer covered benefits under current insurance plans. Scar revisions, skin rashes/ulcers/breakdown, may be covered under more generous plans but this is a rare event today. Occasionally, associated hernias may be considered a covered procedure. If you work for a large employer, you may carry more clout with your insurance carrier through your human resource department.

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

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Comments (1)

Dominicantastee 24 Sep 2012

Yes, if it was due to weight lost they will pay for panniculectomy an tummy tuck. They now considering tummy tuck a necessary depending on the amount you lost. (My government insurance paid for it without any objection)

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