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Insurance Coverage for Umbilical Hernia Repair with Tummy Tuck?

asked 2 years ago by Chan05 in miami
Latest answer by Caroline Min, MD
Question viewed 970 times
Tags: insurance

Large umbilical hernia (considering Tummy Tuck) with some loose skin. I only weigh 121 & my height is 5"4. Currently, my weight is less than what it was when I got pregnant.

After calling several plastic surgeons that accept my insurance, many have stated they do not repair umbilical hernias. I have received quotes from 2 different PS's and the anesthesia fees make up at least 25 % of the cost.

Is there any way to go about having my insurance cover part of my surgery? I live in Miami, Fl (if that helps).

2 answers to Insurance Coverage for Umbilical Hernia Repair with Tummy Tuck?

+1

Insurance will cover hernia repair but not cosmetic surgery

Your insurance should cover all aspects of the hernia surgery (anesthesia, facility and surgeon fees) and if your plastic surgeon does not perform hernia repair, he or she can get a general surgeon who does to do it at the same time as your tummy tuck. Even if you have the hernia repaired at the same time as a tummy tuck, your insurance will only cover the costs of surgery related to the hernia repair. The anesthesia and facility fees will be billed separately for the tummy tuck. Anyone... more
Caroline Min, MD

Los Angeles Plastic Surgeon
+1

Sorry, no such luck

Generally, cosmetic procedures are charged for facility and anesthesia either based on the time or the procedure, but usually it is a fixed cost and is very much below what an insurance company would be billed for the same amount of time. Basically you are getting a significant discount for paying for your procedure out of pocket. That said, when cosmetic procedures are combined with medically necessary ones, the start and stop times of each procedure are noted separately, and the insurance... more
Elizabeth A. Kinsley, MD

Covington Plastic Surgeon

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