Tummy Tuck Q&A

94%

WORTH IT RATING

2,305 Reviews

Ask a Question

View Before and Afters

Average Tummy Tuck Cost: $7,950

Learn about Tummy Tuck

7,750 people and 865 doctors are talking about Tummy Tuck

Get Free Email Updates

When is Tummy Tuck Medically Neccessary?

asked 2 years ago by kwrightbigk in richmond,va
Latest answer by Michael A. Jazayeri, MD
Question viewed 3,587 times
Tags: abdomen, insurance

When would a tummy tuck be medically neccessary? Cosmetic surgery would not be covered by insurance, only if medically needed.

15 answers to When is Tummy Tuck Medically Neccessary?

Tummy tuck, abdominoplasty or panniculectomy

First we need to define some terms. A panniculectomy removes the overhang(sometimes called an "apron") of skin and fat that in some people hangs over the pubic area. A panniculectomy does not tighten up the abdominla muscles nor does it address any loose skin or excess fat of the upper abdominal area. An abdominoplasty (often called a " tummy tuck") removes excess skin and fat of the entire abdominal area and tightens up the muscles underneath. A panniculecotmy may... more

Susan E. Downey, MD
Los Angeles Plastic Surgeon

Medically necessary Tummy Tuck

The answer to your question depends on the exact description of what the problem is. There are two procedures regarding the abdomen: tummy tuck (abdominoplasty) and panniculectomy. A tummy tuck is considered cosmetic in nature and is NEVER covered by insurance. If you have a large, heavy apron of skin which is hanging over your lower abdomen and is causing back pain, infection and irritation, then a panniculectomy is performed. The procedure removes the excess, hanging skin and is... more

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon

Tummy Tuck is NEVER medically necessary

NEVER. Tummy tuck is a cosmetic procedure. Panniculectomy (removal of excess skin after large weight loss) can sometimes be covered in extreme cases where the skin is causing repeated infections, cancer, or some other health problem that cannot be managed otherwise.

Armando Soto, MD
Orlando Plastic Surgeon

www.DrArmandoSoto.com

Tummy tuck and medical necessicity

The answer is never. Tummy tuck is by definition, a cosmetic procedure. Lesser procedures like panniculectomy may be an insurance covered procedure- it includes removal of skin and fat, but no muscle tightening. Still, that would be dicey too, depending on your particular coverage.

Scott E. Kasden, MD
Dallas Plastic Surgeon

Tummy Tuck

Cosmetic Surgery is never covered by health insurance. While insurance companies sometimes call a procedure cosmetic it may be reconstructive. A reconstructive procedure is one where you restore the abnormal to normal, a cosmetic procedure improves on the normal. If the procedure in question is a tummy tuck you are improving on a normal condition presumable excess skin and far. When the excess skin hangs down and covers the pubic area it is a panniculectomy and sometimes the health... more

Walter D. Gracia, MD
Arlington Plastic Surgeon

Tummy Tucks rarely medically necessary

Insurance does not always cover everything that might be considered necessary in a medical sense, and procedures that are most often done for cosmetic reasons sucha as abdominoplasty are particularly problematic for them. It's easier just to deny coverage for such procedures categorically rather than on a case-by-case basis. When they do cover it, there would need to be clear evidence that the condition is causing significant medical problems not correctable without surgery, and this is... more

Richard Baxter, MD
Seattle Plastic Surgeon

Tummy tuck and insurance

It has been my experience that the only procedure that insurance will cover is a panniculectomy. That is removal of the overhanging skin and fat from below the belly button. They cover that whn a patient has symptoms of uncontrolled rash and infection and well as hygeine problems. All else is generally considered as cosmetic.

John P. Stratis, MD
Harrisburg Plastic Surgeon

Defining "Medical Necessary" for Panniculectomy - "Tummy Tuck"

Thanks to the medical insurance companies and Medicare / Medicaid the English language has undergone an Alice in Wonderland like transformation. I'll give you a few examples:- ELECTIVE surgery - surgeon and / or patient choose the TIME / place of surgery (opposite of EMERGENT surgery (such as burst appendix, stab to heart) when one needs to be rushed to the OR)- COSMETIC surgery - a component of Plastic Surgery in which we operate on NORMAL people to improve their appearance- RECONSTRUCTIVE... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Tummy tuck never medically necessary.

Hi. After extreme weight loss, people can develop a big roll of hanging skin over their groins. Removing this (panniculectomy) is medically necessary. But a regular tummy tuck is not.

George J. Beraka, MD
Manhattan Plastic Surgeon

Insurance coverage of tummy tuck (abdominoplasty)

Each insurance plan will vary according to their coverage of procedures. However, most insurance plans will not reimburse for a tummy tuck especially the liposuction component or diastasis repair. In rare instances, instances of severe birth trauma or following massive weight loss with complications of skin breakdown, coverage is provided. Therefore, I would seek evaluation by a physician and have a letter of predetermination of benefits submitted to your insurance carrier. A photograph... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Tummy tuck and medical necessity

A tummy tuck may be medically necessary if the skin overhangs to such a degree that chaffing and chronic dermatitis and infections result underneath and do not heal. However, you should contact your insurance carrier because not all consider surgery as a treatment at any time and may not pay for it.

Ricardo Izquierdo, MD
Chicago Plastic Surgeon

Medically Necessary Tummy Tuck

Tummy tucks are rarely, if ever, deemed medically necessary. On very rare occasions, a panniculectomy may be a covered procedure if there is a history of fungal infections, etc. However, this is a very different procedure than a true tummy tuck and most plastic surgeons are unwilling to perform a tummy tuck for panniculectomy reimbursement. Therefore, tummy tucks are almost always paid out-of-pocket by patients.

John Whitt, MD
Louisville Plastic Surgeon

Tummy Tuck and medical necessity

A tummy tuck is a purely cosmetic operation and would not be considered medically necessary at any time. A panniculectomy, in which only the overhanging skin is removed, is considered medically necessary in massive weight loss patients who develop a rash in the skin fold. Every insurance carrier has its own policy on this so it would be best to check with them if this is your situation. Good luck.

Nina S. Naidu, MD
New York Plastic Surgeon

Tummy Tuck never covered by insurance

Cosmetic Surgery is NEVER covered by insurance no matter how you want it to be. IT IS NOT! Fraud to an insurance company is a felony and loss of the MD license. Please be careful.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Tummy Tuck is never medically necessary

A tummy tuck is a cosmetic procedure. It involves removing the skin in your lower abdomen and tighening the abdominal muscles. A cosmetic procedure is not covered by insurance. A patient who is having a panniculectomy is sometimes covered after a gastric bypass surgery to remove the skin that is causing rashes or skin breakdown. This does not usually include the tightening of the muscles which most patients need. Good luck.