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What is the Best Way to Plead Tummy Tuck Case to Insurance?

asked 1 year ago by ShayBe in Baltimore, MD
Latest answer by Ricardo A. Meade, MD
Question viewed 1,095 times
Tags: hernia, insurance

I'm a mom of 2. After 2nd child I noticed that I had umbilical hernia. I got that repaired. In the Dr's summary he said "The abdominal wall was extremely thin around the hernia, and for this reason, the fascia was debrided in a longitudinal ellipse." 2 years later I start working out, abs especially, and another hernia has appeared! How disheartening! My Dr says that it's a hernia and gives a referral to a general surgeon. I don't want to get this repaired for it to only come back. Any Advice?

15 answers to What is the Best Way to Plead Tummy Tuck Case to Insurance?

+2

Insurance hernia repair

If there is a true hernia, then a repair would clearly be covered by your insurance company.  A tummy tuck will not be covered by your insurance company.
Ricardo A. Meade, MD

Dallas Plastic Surgeon

www.DoctorMeade.com

+2

Insurance coverage of a tummy tuck

A tummy tuck is a safe and effective procedure to contour the abdomen, create a tight waist, and remove extra skin, fat, and stretch marks. Many of our patients have this procedure done at the same time as another surgery such as a gynecological procedure or a hernia repair. If you have a pre-existing umbilical hernia, your best bet is to work with a plastic surgeon who is board-certified and has great deal of experience with abdominoplasty, liposuction, and body contouring. They... more
B. Pat Pazmino, MD

Miami Plastic Surgeon

www.miamiaesthetic.com

+2

Tummy tuck and hernia repair

What is the Best Way to Plead Tummy Tuck Case to Insurance? I'm a mom of 2. After 2nd child I noticed that I had umbilical hernia. I got that repaired. In the Dr's summary he said "The abdominal wall was extremely thin around the hernia, and for this reason, the fascia was debrided in a longitudinal ellipse." 2 years later I start working out, abs especially, and another hernia has appeared! How disheartening! My Dr says that it's a hernia and gives a referral to... more
Farbod Esmailian, MD

Orange County Plastic Surgeon
+2

Tummy Tuck

You appear to have marked abdominal wall protuberance, related perhaps to abdominal wall weakness, but also to your weight.  It will be difficult or impossible to improve by abdominal exercise, and I've had patients built like yourself with disabling back problems.  My recommendation is to lose the weight first by seeking professional help, either a reputable weight loss center or, if indicated, by bariatric surgery.  See your primary care physician to discuss. ... more
Steve Laverson, MD

San Diego Plastic Surgeon

feelbeautiful.com

+1

Tummy tuck and insurance

Unfortunately, tummy tucks are not covered by isnurance, but if you have a true hernia, that certainly would be.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Tummy tuck is elective cosmetic surgery

I agree with my colleagues in this case.  A tummy tuck is an elective cosmetic procedure that women undergo to improve the appearance of their abdomen after having children.  Hernias are covered by insurance and there are times that small umbilical hernias are fixed at the same time, and it is conceivable that the insurance would cover the general surgeon (or even possibly plastic surgeon) to repair this during a tummy tuck; however, the tummy tuck is not medically necessary... more
James F. Boynton, MD

Houston Plastic Surgeon

www.BoyntonPlasticSurgery.com

+1

Hernias are covered by insurance, tummy tucks are not

Simply enough, you can have your hernia done and covered by insurance as medically necessary but removing the extra skin and tightening the rest of the muscles in a tummy tuck is not medically necessary (it is cosmetic) and is not covered by insurance.   The two surgeries can be done at the same time but the tummy tuck portion is your responsibility to pay for.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

Tummy tuck and insurance coverage

To be fair, getting insurance to cover a tummy tuck may not be appropriate. Your hernia repair should be covered by insurance as it is a medical condition.
Karol A. Gutowski, MD

Chicago Plastic Surgeon
+1

Tummy tuck is a cosmetic operation

I am a bit wary when a patient seeks insurance coverage for procedures that generally are considered cosmetic, and so are insurance companies. Basically, if you have a hernia, then hernia surgery is medically indicated and is usually done by a general surgeon, although plastic surgeons often repair hernias as well. If you are seeking to COMBINE a medically indicated, insurance-reimbursed hernia repair with an abdominoplasty (tummy tuck), you may be able to avoid a second operation... more
Tim Abou-Sayed, MD

Palm Beach Plastic Surgeon
+1

Recurrent hernia formation of abdomen versus tummy tuck

You are more likely to get insurance coverage if you have this repaired as a hernia. Preventing recurrence may be related to several factors you should discuss with your hernia surgeon.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Tummy Tuck is cosmetic surgery

Hernia repairs are medically indicated and hence covered by insurance.  However, tummy tucks are deemed cosmetic and not medically necessary by insurance companies.  Its cosmetic surgery.
C. Bob Basu, MD

Houston Plastic Surgeon

www.basuplasticsurgery.com

+1

What is the Best Way to Plead Tummy Tuck Case to Insurance?

Sorry no insurance carrie is going to approve coverage for a tummy tuck. Save up to have it done is the best advise. From MIAMI Dr. Darryl J. Blinski
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Abdominal hernia wanting tummy tuck

The only thing resembling a tummy tuck that is covered by insurance is a panniculectomy (removal of marked excess abdominal skin causing medical problems). This is not a cosmetic operation. To make it one, you are responsible monetarily for the additional parts. At the present time, you are not a candidate for either. What you need is a proper diet with exercise to lose the marked excess intraabdominal fat that is causing your hernias to occur.  
Robert T. Buchanan, MD

Highlands Plastic Surgeon
+1

Tummy tuck is a cosmetic procedure.

Tummy tuck (abdominoplasty) is a cosmetic surgery that is not covered by insurance.  Umbilical hernia is covered by insurance.  Your recurrent hernia repair will be covered by insurance.  You can undergo tummy tuck and umbilical hernia repair at the same time.  Plastic surgeons can work together with your general surgeon to perform the tummy tuck at the same time as your hernia repair.  For certain hospitals, they give discounts on OR and anesthesia fees for the... more
Sugene Kim, MD

Houston Plastic Surgeon
+1

Tummy tuck not covered by insurance

Tummy tucks are cosmetic surgery. Hernia repairs are reconstructive surgery.  Cosmetic surgery is paid by you, and recurrent hernia repairs should be covered by insurance. Therefore if you have both done at the same time, part of the cost might be covered by your insurance company. This is something your Doctor and you have to discuss and work out ahead of time with the insurance company.  It will take some effort and time on your part. You cannot expect your insurance to cover the... more
Victor Au, MD

Chapel Hill Plastic Surgeon

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