Tummy tuck with muscle and hernia repair covered by insurance?

I need an umbilical hernia and abdominal muscle repair, and I would like to get a tummy tuck at the same time. I am pretty sure that my health insurance will cover the hernia repair. Is it possible for me to just pay the additional costs out of pocket for the tummy tuck portion of the surgery? Is this feasable? Would most surgeons agree to this? Thanks in advance for your insight!

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14 answers to “Tummy tuck with muscle and hernia...”

A: Yes, tummy tuck can be done at same time as hernia repair

Brooke R. Seckel, MD

Dear Donna, It is quite common to have a tummy tuck at the same time as a hernia repair. You will need to find a general surgeon and plastic surgeon who are willing to work together. The insurance would cover the hernia repair and you would pay an extra fee for the tummy tuck Ask your doctor who plans to do... more

A: Yes, it can be covered

Gregory Turowski, MD, PhD

Hernias are frequently discovered either during a consultation or even during the abdominoplasty surgery (asymptomatic). In both cases, repairs can be covered by the health insurance.

A: Yes, yes, and yes

Kenneth R. Francis, MD

Donna B, In a word or three, yes.  Many surgeons, myself included, would be very accommodating to this type of request.  Your biggest out of pocket concerns might be anesthesia and hospital fees if your surgery is performed in a hospital operating room.  You can save a significant amount of... more

A: Yes, umbilical hernia repair and abdominoplasty at the same time is possible

Sanjay Grover, MD

Yes. It is possible to undergo an umbilical hernia repair and abdominoplasty at the same time. Most insurance plans will cover the umbilical hernia repair; however, they will not cover the abdominoplasty. You should check with your plastic surgeon to see if they accept insurance payments or will assist you in... more

A: Insurance coverage becoming more difficult to obtain for supposedly "covered" features

Stephen A. Goldstein, MD

Health insurance companies are in business to take your premiums and hold onto your money as long as possible. Of course, many factors come into play whether your particular company will cover the medical problems that you mentioned. Much of it has to do with YOUR personal policy with the insurance company. It... more

A: Yes

Daniel Sherick, MD

The hernia should definitely be covered by your insurance. The Tummy Tuck can be done safely at the same time. The two procedures are nice to combine because it means only one recovery for you. You might even save a little money on the cost of the inpatient stay, if one is needed. Good luck

A: Medical costs are covered for medical issues

Robert M. Freund, MD

Although many insurance companies would have you believe that medical problems treated at the same time as a cosmetic procedure, this is more an attempt to not pay for your medical problem. At the least, they should pay for the medical treatments for the hernias, as well as the hospitalization and anesthesia... more

A: Yes, umbilical hernias are typically covered

Scott E. Kasden, MD

I find that umbilical hernias are common, and covered by insurance.  The tummy tuck is cosmetic and therefore, not covered.  I will either do the umbilical hernia or have a general surgeon do the hernia repair.  This is a great time to do the abdominoplasty, and you and your plastic surgeon... more

A: Depends on how good your insurance is.

William B. Rosenblatt, MD

An umbilical hernia repair is a relatively simple procedure usually performed by a general surgeon and only involves a small incision around your umbilicus. This may be covered by your insurance but is a much smaller procedure than a tummy tuck. A full tummy tuck involves a larger incision in your lower... more

A: Tummy tuck and hernia

Steven Wallach, MD

The hernia should be covered by insurance.  The tummy tuck portion will not be covered.  You will most likely have to pay for the extra OR time and anesthesia as welll as your surgeon's fee for the tummy tuck.

Comments

DonnaB63
4 posts
1 Feb 2009

Thank you for your valued opinions regarding my question. The decision for plastic surgery is a long and difficult journey. I would like to make a sound decision in choosing my plastic surgeon, however in all honesty, cost will definitely play a significant part in that decision making. I wish that weren't the case. Your insight will definitely aid in my decision making. Thanks again!

Tom from RealSelf
480 posts
2 Feb 2009

DonnaB63 thank you as well for posting a question that received a dozen medical answer--so far. Your willingness to share your consideration process will help hundreds of others. Best wishes, Tom (founder, RealSelf.com)

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