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Pain in Lower Abdomen From Excess Skin, Any Chances Insurance Will Pay for Tummy Tuck ?

After I lost about 150 lbs,now my abdomen hangs really low and covers my pubic area.During my Periods it hurts a lot in the lower abdomen,It feels like my ovaries are just hanging and someone is putting and hard.It is very painful I can barely walk normal during that time.It also happens after I workout or I am cleaning myself under the flap, that area is very sensitive.I have a LOT of skin hanging beyond my c-section area about 6 Inches below.Could it be due to hanging skin & will Insurace Pay?

Doctor Answers (8)

Insurance Coverage for Tummy Tuck

+1

Thank you for the question.

Unfortunately, unless you can demonstrate repeated infections  related to the redundant skin flap,  insurance companies will not cover the tummy tuck procedure. Given that the pain you are experiencing happens during your menstrual cycle it is  not likely to be related to the abdominal wall skin.  You may want to see your OB/GYN for consultation.

I hope this helps.


San Diego Plastic Surgeon
5.0 out of 5 stars 722 reviews

Pain from excess abdominal skin

+1
  1. panniculitis  , or infections of the fat of the lower skin may be covered
  2. chronic intertriggo ,  infections in the fold may be covered
  3. most plans have gotten very difficult   
  4. diabetes or other medical conditions and 
  5. history of massive weight loss help

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 18 reviews

Any Chances Insurance Will Pay for Tummy Tuck ?

+1

Insurance will NEVER knowingly pay for Tummy Tuck (Abdominoplasty) which involves relocation of the umbilcus, skin resection both below and above the belly button and muscle repair. Depending on the terms of YOUR policy it MAY partially pay for removal of the skin overhang, Panniculectomy (Apron Resection).

Peter A Aldea, MD

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 60 reviews

Insurance may cover a panniculectomy

+1

In general, insurance companies do not cover tummy tucks but they may cover removal on excess skin and fat on the lower abdomen.  This procedure is known as a pannuculectomy.  A tummy tuck normally includes removing excess skin and fat, tightening the abdominal muscles and repositioning the skin around the belly button.  As the muscle tightening and moving the skin around the umbilicus have not been shown to relieve any physical symptoms, they are not generally covered by insurance.  The removal of excess skin and fat has been shown to relieve physical symptoms, particularly pain and irritation due to rashes under the fold of skin and, therefore, may be considered medically necessary. 

If you get insurance approval for a panniculectomy, you can still have a tummy tuck at the same time and your out of pocket cost should be less as insurance is covering a portion of the surgery, anesthesia and facility.

James McMahan, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 11 reviews

Tummy tuck from weight loss

+1
Congratulations on losing all that weight! It would be nice if insurance companies would cover the cost of a tummy tuck, especially in your case, because of the symptoms you have, however, most insurance companies will not cover the cost of an abdominoplasty regardless of your symptoms. You can always ask them and try to get it preauthorized, but it is unlikely.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 11 reviews

Excess Hanging Skin After Massive Weight Loss

+1

See video response for full answer.   Excess skin from weight loss can cause chronic rashes which can be treated by removing the pannus.  Insurance may cover this.

Gary D. Breslow, MD
Paramus Plastic Surgeon
5.0 out of 5 stars 30 reviews

Abdominoplasty

+1

insurance does not pay for abdominoplasty,also excess skin does not result in pain.

 

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.5 out of 5 stars 10 reviews

Insurance coverage for tummy tuck?

+1

Insurance companies will not pay for a tummy tuck. What they will occaisionally pay for is a "panniculectomy". This is the removal of just the skin which hangs down over your pubic area, or lower tummy crease. In order to have this covered, it has to be "medically neccesary", and you need to be suffring from chronic skin irritation and breakdown as well as pain unresponsive to non-surgical treatment from your primary care doc. It needs to be documented for at least 3-6 months. If it is covered do not expect the results of a tummy tuck. While it will certainly help with some of the costs, you will need to pay extra if you really want the cosmetic appearance that a tummy tuck gives you. Good luck. 

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 24 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.