Will Insurace Cover Tummy Tuck to Fix Painful Rashes?

I want a Tummy Tuck because where the fat hangs, I'm always taking care of rashes and small cuts. This is very painful and I need help to tuck the stomach area. Will insurance pay for this?

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11 Doctor Answers | Asked by serenaann in Round Rock

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Will insurace coverage for Tummy Tuck or Panniculectomy for painful rashes

Insurance do not pay for cosmetic surgery, An Abdominoplasty is a cosmetic procedure and the vast number of insurance companies will NOT knowingly pay for it . An operation they MAY pay for is a PANNICULECTOMY (CPT 15831), the isolated cutting off of the Tummy overhang. Period. A relatively short procedure with no undermining of the skin to the rib cage edges. No removal of skin excess above the transverse tummy fold with relocation of the belly button. No muscle repair. While a... more

Medical documentation required for consideration

Having reviewed cases for insurance carriers, and being familiar with their criteria, most insurance companies require that the rash has been documented by a physician for at least six months and has not been improved with nonsurgical treatment. By that I mean, topical antibiotic powders and creams, oral antibiotics and what they consider "conservative therapy". If your case meets that criteria, then they may authorize a panniculectomy, which is just removing the overhang of skin... more

It may

If you have a large pannus or hanging tissue, it may be possible for your insurance to pay for removal of the fat. This is not an abdominoplasty but a panniculectomy and does not involve tightening the muscles and may involve removal of the belly button. Insurance will not pay for a standard abdominoplasty.

Tummy tuck and panniculectomy.

Hi! Here's a summary for you. You would benefit by both a tummy tuck and a panniculectomy which of course are done together. The tummy tuck makes your whole stomach look better, it is cosmetic, and it is not covered by insurance. The panniculectomy cuts out the hanging apron of skin and fat, it is medically indicated, and it can be covered by insurance, but you must get pre-approval from the insurance company. If you get insurance approval for the panniculectomy and you do both, then you... more

Tummy tuck vs panniculectomy

A tummy tuck is a cosmetic procedure to remove excess skin and repair the stretched out anterior abdominal wall muscles. I personally also do liposuction of the upper abdomen, flanks, hips, upper buttocks and back to achieve the best shape. A panniculectomy is done to get rid of the excess skin overhang and stop skin rubbing on skin which results in the medical problems you are experiencing. This might be covered by your insurance. If that is what you are interested in, I would refer you to... more

Tummy tucks covered by insurance

It is rare to see an insurance company cover a tummy tuck for any reason. You can always try though. It sounds like you would benefit from one but don't be surprised if the insurance won't get involved. As soon as they hear the words "tummy tuck" they turn and run!

Insurance for Tummy Tuck

Occasionally, insurance covers excision of excess skin when rashes occur under the overhang of tissue. Documentation by a family doctor over a period of a year is usually necessary. Various treatments also need to be documented. I have seen patients who have undergone gastric bypass and their abdominal lipectomy is covered for similar reasons. Most of the time, it depends on the insurance company.

Tummy tucks can be covered by insurance in some cases

It really depends on your specific case and your insurance, so I would recommend having an exam and seeing what your plastic surgeon thinks. Some insurance carriers are stricter than others, and they may want photos, etc. before they will agree to pay for it.

Insurance coverage for tummy tuck

In most cases, insurance will not cover a tummy tuck or abdominoplasty. This is the medical terminology for a cosmetic procedure. However, in some cases, insurance companies will cover a panniculectomy, which is similar to a tummy tuck but is done for medical reasons. In most cases, the reasons are massive weight loss, chronic sores, etc. This procedure typically just involves removing the excess skin, but does not involve tightening the muscles.

Insurance coverage for tummy tuck

In rare circumstances, including a documented history of rashes and wounds, an insurance company may cover a procedure called a panniculectomy. This is a wedge excision of overhanging skin. It's important to realize that this is a functional operation, not a cosmetic one, and the results are not comparable to a tummy. In a tummy tuck, the skin is removed and the muscle is tightened to try to obtain a flat, pleasing contour of the abdominal wall. In a panniculectomy, extra skin and fat... more

Insurance coverage for a tummy tuck (abdominoplasty)

Although insurance companies have paid for tummy tucks in the past due to either muscle repair or complications such as rashes, etc. it is increasingly less likely that they will do so. Even if it is covered, they are more likely to pay for the less complicated procedure of panniculectomy (no muscle repair and no liposuction). To help find out if your specific insurance company will cover this procedure, you can have a physcian compose a predeterminaltion of benefits letter to your... more