Tummy Tuck with Muscle and Hernia Repair Covered by Insurance?

Good question.  Both of these procedures can be done at the same time.  Tummy tucks and liposuction are cosmetic so they are not covered through insurance and is always the patients responsibility.  The hernia portion of the surgery is something your insurance might cover.Best of luck to you

Thank you for your question regarding combining an umbilical hernia and muscle repair with a tummy tuck. It’s great that your health insurance is likely to cover the hernia repair, as this is considered a medically necessary procedure. Combining this with a tummy tuck, however, is primarily cosmetic, and it’s common for patients to pay out-of-pocket for the cosmetic portion.

Many surgeons are open to combining these procedures because it can be more efficient for the patient, requiring only one surgery and recovery period. In these cases, your surgeon would likely bill your insurance for the hernia and muscle repair, while you would pay for the tummy tuck portion directly. This can make the process more feasible and cost-effective for you.

I recommend discussing this option with your plastic surgeon and insurance company to clarify what will be covered and how the combined billing would work. Surgeons who regularly perform tummy tucks with hernia repair are usually familiar with this arrangement, and it’s a practical option for many patients.

Sincerely,
Dr. Katzen

This is a frequent question, thanks for asking. You are correct in your assumption that your insurance company will likely pay for your hernia repair but not your tummy tuck. It is not uncommon to perform these two procedures at the same time. You would be responsible to pay the out of pocket costs for the tummy tuck (including the facility fee and anesthesia time for the tummy tuck portion of the procedure). By combining the two procedures you will only have to go through one recovery period. Good luck!

Unfortunately, insurance does not cover a tummy tuck. Occasionally with documentation of recurrent infection they will pay for a panniculectomy (simply removing loose skin).#tt#tummytuck

Thank you for your question.  Repair of a small, uncomplicated umbilical hernia is very commonly performed by the plastic surgeon as a part of the tummy tuck operation.  Insurance will usually cover the hernia repair; the tummy tuck (with associated OR and anesthesia time) is paid for out of pocket.  In the event that insurance approval for the hernia cannot be obtained, many plastic surgeons will perform this either free of charge or at a small additional fee.