I need to have my hernia repaired in my abdomen that is the size of a cantaloupe. The insurance will cover that; but if I wait 3-5 months to have the Tummy Tuck, will the insurance cover it? Also, is it safe to do the 2 surgeries seperately?
Will Insurance Cover Tummy Tuck Surgery if Delayed?
Doctor Answers (4)
Tummy Tuck and Insurance
Tummy tuck is a cosmetic procedure and is not covered by insurance. Now, you may be able to have a panniculectomy, which is the sole removal of the skin and fat, without the muscle plication and undermining if you qualify.
What is commonly done is to have the hernia repair done and have your tummy tuck at the same time. You would have your hernia repair covered by the insurance and then would have to pay for the tummy tuck portion out of pocket (cash).
Abdominoplasty and Hernia Repair Insurance Coverage?
Of course, much depends on your insurer, but it's unlikely that insurance will cover the abdominoplasty regardless of when it's done. Of our recent cases involving a covered procedure, like a hernia repair, and a cosmetic procedure, like an abdominoplasty, insurance won't cover the abdominoplasty or any anesthesia, operating room fees or surgeon's fees associated with it.
As far as safety, you're usually safer to minimize the number of times you're anesthetized, so it would probably be a better choice to have the procedures done at the same time. It saves you an additional anesthesia experience and you minimize your recovery time as well. Additionally it will probably cost you less to do the procedures together.
Your best bet is to discuss this with your surgeons and let them advise you. They have access to your medical records and your insurance coverage and are in the absolute best position to guide you.
Insurance does not cover 'tummy tuck' surgery
It sounds like you have a large abdominal hernia which should be repaired. Depending on the anatomy of your hernia, it may be technically possible to do a hernia repair and abdominoplasty at the same time, but I do not think such a combination surgery is in your best interest. It would be a long procedure, and I believe the risk of wound infection may be higher with this combination surgery.
It would make the most sense to have your abdominal wall hernia repaired, and wait several months before having tummy tuck surgery. Make sure your plastic surgeon has access to the detailed operative report from the surgeon that did your hernia repair. Bring this report in with you when you meet your plastic surgeon for the consultation.
Regarding your tummy tuck insurance payment question, it is unreasonable to expect for your insurance company to pay for what is regarded as a cosmetic operation.
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Insurance will probably not cover Tummy Tuck
Tummy tuck surgery is considered cosmetic by most insurance companies unless it is simply billed as something else. It is not the same as a panniculectomy (simple removal of a lower abdominal "apron.") Be careful on this one. It might turn into a billing nightmare.
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.