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).
Would Medicare Pay for Tummy Tuck if I've Had Back Surgery and It my Stomach Hurts my Back?
Doctor Answers 13
Medicare coverage for an abdominoplasty
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.
Medicare does not cover an abdominoplasty (tummy tuck).
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.
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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!
Medicare never will do it/ ninguna aseguradora cubre cirugia plastica estetica
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
Tummy tucks are not considered to be a medically necessary procedure. Medicare will not cover a tummy tuck
Tummy Tuck and Insurance Coverage?
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”.
Insurance coverage for abdominoplasty
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.
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.
Insurance and tummy tuck
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!
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.