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Would Medicare Pay for Tummy Tuck if I've Had Back Surgery and It my Stomach Hurts my Back?

Doctor Answers (13)

Tummy Tuck Paid by Insurance

+1

     If you have a large dependent pannus, you may be able to get the panniculectomy covered under insurance.  Then, you could ask the plastic surgeon to perform the cosmetic portion of the procedure considered the tummy tuck (that fee would be out of pocket).


Los Angeles Plastic Surgeon
5.0 out of 5 stars 180 reviews

Medicare coverage for an abdominoplasty

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Medicare will only cover surgical procedures that are medically necessary.  It is very unlikely that there would be any coverage for an abdominoplasty even under the most extreme of circumstances.     On occasions they will cover a panniculectomy which is an excision of overhanging skin.   

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 8 reviews

Medicare does not cover an abdominoplasty (tummy tuck).

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Although patients sometimes claim that back pain is improved by a tummy tuck, this is not a recognized therapeutic modality for spine problems.  Medicare will not pay for the procedure.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 7 reviews

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Never.

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I have never seen a real abdominoplasty covered by medicare.  You may very well have back pain and perhaps it might be helped however medicare does not believe this is a reconstructive indication for tummy tuck!

Evan Sorokin, MD
Cherry Hill Plastic Surgeon
4.5 out of 5 stars 36 reviews

Medicare never will do it/ ninguna aseguradora cubre cirugia plastica estetica

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any company in any country would cover  any aesthetic surgery except reconstructive problems.

ninguna aseguradora cubre  cirugia estetica en ninguna parte del mundo , solo cubren cirugia reconstructiva

Ramon Navarro, MD
Mexico Plastic Surgeon

Medicare

+1

Tummy tucks are not considered to be a medically necessary procedure. Medicare will not cover a tummy tuck

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 9 reviews

Tummy Tuck and Insurance Coverage?

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No, health insurances will not cover tummy tuck surgery.  For the rare patient who has an abdominal wall pannus causing  significant problems,  health insurance companies may have panniculectomy as a “covered benefit”.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 684 reviews

Insurance coverage for abdominoplasty

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Insurance will not cover abdominoplasty. Beware of anyone who tells you otherwise. If they will lie to your insurance, they will lie to you. Seek a board certified plastic surgeon.

John Squires, MD
Denver Plastic Surgeon
5.0 out of 5 stars 48 reviews

Insurance

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I'm sorry, but Medicare will not pay for a tummy tuck as they consider it a cosmetic procedure.   Please visit with a board certified PS in your area to learn more about your options.

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 114 reviews

Insurance and tummy tuck

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Thank you for your question.  It is unlikely that your insurance or Medicare will pay for a tummy tuck.  You may find that your insurance will cover a panniculectomy which is removal of the skin on the lower abdomen below the belly button.  This procedure does not give the aesthetic results of a tummy tuck because the upper abdominal skin is not moved inferiority over the belly button and the muscles are not repaired.  Additionally, you must document severe symptoms of pain, rashes, skin infections, etc and prove that you have failed conservative measures.  The insurance company has to authorize this procedure ahead of time or you will be stuck with the bill.  Medicare will not pre-authorize, so you have to be very careful with documentation or you will likely have to pay out of pocket.

If you can get the authorization for a panniculectomy, it is advisable to pay the difference out of pocket to upgrade to a tummy tuck.  The abdominoplasty procedure will tighten the muscles and remove as much skin as needed to give the optimal result.  Be sure to discuss your financial responsibility up front with your board certified plastic surgeon to avoid any misunderstandings and financial surprises after surgery.  Good luck!

Matthew H. Steele, MD
Fort Worth Plastic Surgeon
5.0 out of 5 stars 36 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.