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Common for Insurance to Cover Tummy Tuck?

After having had three c-sections, my lower belly has loose skin and a huge smiley face. I would like to know, is it common for insurance to cover tummy tuck to remove the excess skin?

Doctor Answers (14)

Tummy Tuck

+2

A tummy tuck or abdominoplasty procedure is a cosmetic procedure and not covered by insurance. A panniculectomy is removal of the fat and skin in the lower abdomen without the tightening of the muscles. This may be covered by insurance but it is usually approved for patients with large lower abdominal pannus with skin issues such as rashed and infections.


Orange County Plastic Surgeon
5.0 out of 5 stars 46 reviews

No

+1
You will have to consult your insurance provider to find out if your tummy tuck is covered. However, in general, the answer would be no unless it would resolve a physical impairment directly caused by excess skin in the area you want to target, and a tummy tuck is proven to be the most suitable treatment for you.

However, you may be able to still cover your surgery with financing. Payments can be as little as a couple hundred dollars a month.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 74 reviews

Common for insurance to cover tummy tuck?

+1
Hello! Thank you for your question! Surgical procedures for aesthetic purposes, to improve appearance, are not covered by insurance. Typically, these as well as complications resulting from such procedures are the responsibility of the patient. Procedures that are meant to correct functional issues and those which cause health-related issues should be covered by your insurance as a medical necessity, with proper examination and documentation. Some insurance plans have exclusion criteria for certain procedures. Also, it is an obligation of the surgeon not to attempt to authorize purely cosmetic procedures through insurance.  Typically this is a cosmetic procedure and should not be covered. 

Discuss your issues and complaints with a board-certified plastic surgeon to discuss these as well as to examine and assist you in deciding which procedure(s) will be the best for you. A discussion of the advantages and disadvantages will take place along with the risks and benefits. Certainly, pay in advance prior to your surgical procedure and options such as financing are available if you qualify. Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

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Common for Insurance to Cover Tummy Tuck?

+1
Unless there is some unusual circumstance, insurance companies generally do not cover tummy tuck surgery. In other words, insurance companies do not consider this operation medically necessary. Sometimes, however insurance companies will cover excision of lower abdominal wall skin/apron;  this operation is called a panniculectomy. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
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Insurance Coverage for Tummy Tuck

+1
Thank  you for your question.  Unfortunately, both mini tummy tucks and full tummy tucks are considered cosmetic procedures and therefore are not typically covered by insurance.  However, many surgeons do offer financing options and/or payment plans which might help you spread the out of pocket expense over time.  Good luck.

Mark Deutsch, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 11 reviews

Tummy tuck is cosmetic and is not covered by insurance

+1

A true tummy tuck (tighten skin, abdominal wall) is considered cosmetic and is not covered by insurance. However, a VERY large area of loose skin may be covered and would be called a panniculectomy. You would need to show that this large fold of skin is causing some kind of medical problem such as frequent skin infections and rashes. After 3 c-sections, you would probably do best with a cosmetic tummy tuck. Ask your plastic surgeon which procedure would be best for you.

Parham Ganchi, PhD, MD
Wayne Plastic Surgeon
5.0 out of 5 stars 59 reviews

Tummy tuck or abdominoplasty is a cosmetic operation.

+1

Insurance does not cover a tummy tuck. Loose skin and stretched out abdominal muscles are not considered a "functional" medical problem, but are cosmetic. The only procedure an insurance co. might cover is a panniculectomy. This is a condition mainly seen in patients who underwent massive weight loss and now have an abdominl fat apron that covers the pubic area or even can reach down to the mid thighs. Often these patients have infections and skin breakdown in the folds. Removing this excess skin only is a panniculectomy. It is performed mainly by general surgeons ( oddly, they like to call this a tummy tuck). It is not a tummy tuck, it is part of a tummy tuck.

George Marosan, MD
Bellevue Plastic Surgeon
5.0 out of 5 stars 10 reviews

Consider a Cosmetic Tummy Tuck to Address your Concerns

+1

An abdominoplasty could fully correct the loose muscle and excessive skin resulting form three children and a c-section scar. This is an elective cosmetic procedure. I know of no insurance companies that would cover it. You might be able to see your OB/Gyn for evaluation of a scar revision though and this is sometimes covered however it sounds like you may require more than a scar revision.

Charles Perry, MD
Sacramento Plastic Surgeon
4.5 out of 5 stars 15 reviews

Tummy tuck surgery is not covered by insurance

+1

Hi,

Tummy tuck surgery is not covered by insurance companies in the US. This is considered to be an elective, cosmetic procedure which is specifically excluded under insurance contracts. After three C-sections, the appearance of your abdomen as you have described it would be considered a cosmetic issue. A panniculectomy for hanging skin (as described my colleagues) is generally only covered in patients who have undergone massive weight loss procedures. Be careful of anyone who advises you that they can get this surgery covered for you, as this is insurance fraud. Good luck. /nsn

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.0 out of 5 stars 5 reviews

Insurance won't cover a tumy tuck

+1

As the other doctors have said, a tummy tuck is considered cosmetic by insurance and as such it isn't covered. Even the rectus diastasis is cosmetic and a diastasis is not a hernia.

Basically, as far as insurance is concerned, if you CAN'T live with something it is "functional" or "medically necessary" while if you CAN survive with something even if you don't like it, it is "cosmetic."

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 51 reviews

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.