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Is Tummy Tuck for Yeast Infection Covered by Insurance?

Are yeast infections enough to have your insurance company pay for a tummy tuck? My primary doctor told me that I could have about 10 pounds of fat removed from my stomach which causes yeast infections, she told me that a Tummy Tuck would be covered by my insurance, is this true?

I am having no luck in the Boston area to find a surgeon to perform this operation for me. What should I do? I am miserable with myself!

Doctor Answers (8)

Is tummy tuck for yeast infection covered by insurance?

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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.

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. Insurance companies will vary on coverage and is always reasonable to discuss your issues with your surgeon and primary care. It would behoove you to get as much information as possible and even call your insurance yourself. 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!


Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Insurance tummy tuck

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Hi,

  It is variable as to how the insurance companies cover or do not cover pannus excisions or tummy tucks.  It would be more rare for an insurance company to cover the full tummy tuck and it would be equally rare to find a good qualified plastic surgeon who would do the full deal under your insurance plan.

  Some companies cover the pannus excision. If that is all you need, either a general surgeon or a plastic surgeon can handle it.  It is merely cutting off the tissue that is hanging down and touching the lower tissues giving you the yeast infections.  If that is all you want, then call your insurance company and see how they want to handle it.

 If it is more of a body contouring (beyond the pannus excision), then you need to talk to a plastic surgeon about the muscle tightening etc. 

              Steven M. Lynch, M.D.

Steven M. Lynch, MD
Albany Plastic Surgeon
5.0 out of 5 stars 8 reviews

Tummy tuck and insurance

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Each insurance carrier has different criteria for pre-approval of a tummy tuck and rashes.   It is almost never covered. You should check with your insurance carrier.
 

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

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Tummy tucks are not covered by insurance, but a panniculectomy might be covered

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A tummy tuck addresses fat and skin in the upper and lower abdomen, and it includes tightening of the muscles in the abdomen.  A tummy tuck is always cosmetic in nature and never covered by insurance.  A panniculectomy is removal of lower hanging abdominal skin.  If you meet your insurance company's criteria, a panniculectomy would be covered.  Most insurers require a pannus (hanging skin) of a certain size (such as hanging below the level of the pubic bone or to mid-thigh--it varies by insurer).  They also typically require documentation of skin problems, such as your yeast infections, which are recurrent despite adequate treatment.  You'll need to check with your own insurance, or have your plastic surgeon's office check for you, and find out your insurance company's specific requirements for coverage of panniculectomy.

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 23 reviews

Tummy Tuck and Insurance coverage

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Regarding: "Are yeast infections enough to have your insurance company pay for a tummy tuck? My primary doctor told me that I could have about 10 pounds of fat removed from my stomach which causes yeast infections, she told me that a Tummy Tuck would be covered by my insurance, is this true?

I am having no luck in the Boston area to find a surgeon to perform this operation for me. What should I do? I am miserable with myself!"

Your Primary Care doctor is wrong. Non-Plastic surgeons, including Primary Care physicians, are often confused by the multiple operations aimed at flattening part or all of the belly. Here are the operations likened to and confused with a Tummy Tuck (Abdominoplasty)

PANNICULECTOMY (Apron Resection) - Removes the skin overhang / skin fold to allow better hygiene of the area below. Does NOT remove all the loose tummy skin, does not tighten the muscles, does not transpose the belly button and does NOT flatten the tummy and narrow the waist. IT IS NOT A TUMMY TUCK. SOME insurance company may pay for this operation. THIS is the operation your Primary care was confused about.

MINI - Tummy Tuck - Treats ONLY the tummy BELOW the Belly Button. Does NOT remove all the loose tummy skin (ONLY that below the belly button), may involve tightening the muscles below the belly button, does not transpose the belly button, does NOT flatten the entire tummy. IT IS NOT covered by ANY insurance companies.

(Full, Standard) Tummy Tuck or Abdominoplasty - is a Cosmetic Surgery in which ALL the loose tummy skin is removed, the whole length of the tummy muscles are tightened, the belly button is transposed, the tummy pooch is flattened and the waist is narrowed. This operation is NEVER paid for by any insurance company and attempting to pass such charges to them would constitute insurance fraud.

Your options are either to find a surgeon who will perform an insurance covered panniculectomy, have it done at a Plastic Surgery training program, have weight loss surgery followed by a self-financed Tummy Tuck.

Good luck.

Dr. Peter Aldea  

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 66 reviews

Insurance coverage for tummy tuck

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There are many options to re-contour the abdomen. If you have a great deal of abdominal fat and skin and are developing infections in between the folds of skin, you may benefit from a panniculectomy. This is a procedure where the extra skin and fat is removed but no muscle repair is performed. It is possible that this surgery will be covered by your insurance plan. Your best bet is to be evaluated by a board-certified plastic surgeon was a great deal of experience in abdominoplasty and body contouring techniques. They will be able to evaluate your skin and tissue and help you decide which option is best for you.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 69 reviews

Write a letter to your insurance company to determine benefits

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Dr. Brzowski has an excellent response and I would agree.

A tummy tuck is typically a combination of a panniculectomy, muscle repair, and commonly, liposuction. A full tummy tuck treats the skin and muscle above and below the umbilicus.

A panniculectomy typcially removes only the lower abdominal skin which hangs over.

In any event, the best way to determine insurance coverage is to submit a predetermination letter of benefits to your insurance carrier with supporting documents from your internist. This letter is most commonly written by the plastic or general surgeon. Photographs can be helpful.

Call around for surgeons who are willing to perform this service. Typically, there will be a fee or bill generated.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Tummy Tucks are NOT covered by medical insurance

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Because a tummy tuck is a cosmetic surgical procedure, medical insurance companies do not cover the costs involved. Having said that, the problem with yeast infections beneath the skin folds is a medical problem. Treatment for this condition would typically be covered by your medical insurance. The surgical option for treatment of this situation is a different procedure called a panniculectomy.

A panniculectomy is a procedure that only removes the skin fold along the lower abdomen. While this generally results in elimination or improvement of the rashes, it is NOT a tummy tuck. A tummy tuck will remove the majority if not all of the loose abdominal skin as well as tighten the separated muscles. It does much more to flatten your abdomen and has the added effect and benefit of helping rid you of the troublesome rashes. A tummy tuck is more complex and lengthy, and should not be confused with the more limited panniculectomy.

As you look for a plastic surgeon to perform your procedure, be sure that you are seeking the correct procedure. Make certain that you explain what it is you are trying to achieve. If you wish to undergo a tummy tuck instead of a panniculectomy, don't expect your insurance to cover the procedure or ask your plastic surgeon to bill them for it-----it's a cosmetic procedure:)

Brian K. Brzowski, MD
Ogden Plastic Surgeon
5.0 out of 5 stars 29 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.