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I Have Had 3 C-section and Another Surgery So my Tummy Has Sagged for Years Would my Insurance Cover?

Would. My insurance cover a tummy tuck if I have had 3 C- sections and another surgery.my tummy sags alot and hate looking in the mirror

Doctor Answers (6)

Does insurance cover tummy tucks?

+1

Unfortunately, insurance companies will not cover a tummy tuck after Caesarean section as medically necessary.   I can imagine that you are disturbed by the appearance of your abdomen.  Know that it can be improved by abdominoplasty but that you will be responsible for the costs of the surgery. Although an abdominal hernia may be covered, some carriers will deny coverage if you combine this with a cosmetic procedure and that facilities which permit the combined procedure may, in the end, be less cost effective than a pure cosmetic case.


New York Plastic Surgeon
5.0 out of 5 stars 12 reviews

Tummy Tuck is a cosmetic procedure

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Insurance companies generally do not cover tummy tucks as they feel these procedures are not medically indicated and are cosmetic in nature.  Please visit with a board certified PS in your area to learn more about your options.

Dr. Basu

Houston, TX

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 123 reviews

Will my insurance cover a tummy tuck?

+1

Thank you for your question.  As a general rule insurance companies do not cover tummy tucks (abdominoplasty).  There are some conditions such as an abdominal hernia or excessive hanging skin following massive weight loss that may be covered by some insurance companies.  I would suggest that you check with your insurance company and then seek a consultation with a board certified plastic surgeon to see whether your situation is covered by your medical  insurance. . Best of luck.

Donald M. Brown, MD
San Francisco Plastic Surgeon
5.0 out of 5 stars 8 reviews

Insurance coverage for a tummy tuck

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Insurance does not cover a straightforward tummy tuck, even if you have severe back pain and abdominal deformities from wide abdominal muscles.  However, if there is a hernia present with the other problems, insurance will cover that part of the case.  This will usually decrease your out-of-pocket expenses for anesthesia and facility fees.  If you think you have a hernia, check with you local board certified plastic surgeon to verify this and to take the necessary steps to ensure the proper treatment and insurance coverage for you hernia.  I frequently have the general surgeon correct the hernia at the beginning of the case, and then I perform the tummy tuck portion.  This is great for my patients because it corrects to problems at the same time with one recovery period.  Thanks for your question!  Dr. Schreiber...Baltimore Plastic Surgeon

Jeffrey E. Schreiber, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 72 reviews

Insurance coverage for TT?

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Many insurers specifically exclude panniculectomy and tummy tuck procedures. Others have strict guidelines of medical necessity. It is most unusual to have coverage for any procedure that the insurer would consider cosmetic, which this certainly does.

Discussing with a plastic surgeon would be a useful first step. When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.

Thank your for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Will my insurance cover.......?

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Insurance coverage for abdominal contouring procedures is very difficult with the explosion of bariatric surgery 10 years ago.   1st thing to check is whether or not your policy has a rider that excludes panniculectomy.  2nd.  Indications for panniculectomy are largely designed for massive weight loss patients.  The criteria that we see in Richmond VA are

1.  Weight loss in excess of 100lbs

2.  Stable weight following gastric bypass or any other procedure for at least one year

3.  Recurrent, recalcitrant soft tissue infections due to loose overhanging skin

 

They usually like a photograph and what they look for is that the abdominal apron hangs below the pubis (covers the privates)

 

Should you get this approved, this is for panniculectomy which is resection of the excess tissue between umbilicus and pubis.  Does not apply to fascial plication, relocation of the umbilicus, adjunctive use of liposuction, etc.

 

 

Stephen M. Chen, MD
Richmond Plastic Surgeon
5.0 out of 5 stars 16 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.