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Insurance Coverage for Procedures After Breast Lift and Tummy Tuck?

I recently had a Breast Lift and an anchor Tummy Tuck. My question is I now need my pubic area, thighs, and Butt lifted, along with my arms done. My insurance company paid for my BL and TT.

I am wondering will they cover the rest? And they don't but cover the hospital and anesthesia. What is a ball park figure for having all of these done at the same time?

Doctor Answers (8)

Insurance coverage following Massive weight loss or bariatric surgery

+2

I am quite surprised that your insurance company covered these procedures. This is very unusual. That having been said, I would consult with the surgeon who performed the previous procedures and have him/her compose a letter discussing these procedures with your insurance company. That is most likely to determine your level of coverage.


Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Insurance coverage for procedures after breast lift and tummy tuck?

+1
Hello! Thank you for your question! Surgical procedures for aesthetic purposes, to improve appearance, are not covered by insurance. Typically, these as well as complications resulting from such procedures are the responsibility of the patient. Procedures that are meant to correct functional issues and those which cause health-related issues should be covered by your insurance as a medical necessity, with proper examination and documentation. Some insurance plans have exclusion criteria for certain procedures. Also, it is an obligation of the surgeon not to attempt to authorize purely cosmetic procedures through insurance.  These procedures likely will not be covered. 

Discuss your issues and complaints with a board-certified plastic surgeon to discuss these as well as to examine and assist you in deciding which procedure(s) will be the best for you. A discussion of the advantages and disadvantages will take place along with the risks and benefits. Insurance companies will vary on coverage and is always reasonable to discuss your issues with your surgeon and primary care. It would behoove you to get as much information as possible and even call your insurance yourself. Certainly, pay in advance prior to your surgical procedure and options such as financing are available if you qualify. Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Insurance Coverage for Procedures

+1

Thank you for your question. Your insurance is much more generous than most we deal with. The rest of your surgeries could cost you in the 20-30K range, and even as generous as your insurance company was, I have doubts if they will spring for a 20K surgery without a flag being raised. I hope this helps.

Vivek Bansal, MD
Danville Plastic Surgeon
5.0 out of 5 stars 9 reviews

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Insurance coverage for cosmetic surgery?

+1

I am very surprised you managed to get your health insurance to cover cosmetic surgery. This is very rare to have happen. I would recommend you consult with a board certified plastic surgeon to get idea of cost in your area. Pricing varies from doctor to doctor as well as the area you live in. Best of luck.

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Insurance Coverage for Cosmetic Procedures

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It is not often that insurance will cover what is considered "cosmetic" or "elective" procedures, however, in rare cases insurance does provide coverage after gastric bypass or massive weight loss due to medical issues caused by excess skin. You will have to check with your insurance provider to see if the rest of the procedures are covered. My guess is if it didn't cover hospital and anesthesia fees, they probably won't this time around either. It is hard to provide a quote for the procedures without an exam, but many doctors will provide discounts to patients who are undergoing multiple procedures at once. 

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Insurance coverage for a revision of a breast lift and tummy tuck

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The combination of a breast lift and a tummy tuck is an excellent way to recontour the breast and abdomen. Unfortunately, these procedures are considered to be cosmetic and are almost never covered by insurance policies. However, every insurance plan is different and you may benefit from evaluation with a board-certified plastic surgeon who can assess you and create a letter to submit your insurance company for preauthorization.
 

Pat Pazmino, MD
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Insurance coverage for body contouring procedures

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You must have the best medical insurance on the American market. I have NEVER seen or heard of an insurance company knowingly pay for post massive weight loss body contouring procedures much less for touch ups for such procedures.

(Maybe your Plastic surgeon could be persuaded to lecture at one of our national meetings on how he got your surgeries to be approved??)

I join my colleagues in recommending that you ask your surgeon on how to get these procedures paid for since obviously he/she is much better at getting "things done" than the rest of us.

Peter A. Aldea, MD
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Insurance for tummy tuck and breast lift

+1

I must say that without knowing your history this is almost unheard of unless you have a very high end policy. For several years the insurance companies were paying for these procedure after gastric bypass surgery and massive weight loss.

Their policies have changed greatly and have never had a case where the insurance covered those procedures. If they don't cover the surgery you will also be totally responsible for all hospital and anesthesia fees which alone could run $7000.00 for combining the two procedures.

Speak to your doctor to see if he or she will agree to accept the insurance payment for the surgery as they may require you to pay what the insurance does not cover. They may have to write pre-authorization letters with photos before the surgery for approval by the insurance company.

Steven Schuster, MD
Boca Raton Plastic Surgeon
4.5 out of 5 stars 3 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.