I have had four C-sections and have a few areas in my muscle wall that need to be repaired, beyond cosmetic issues. I am only about 10 pounds over my ideal weight but most of it is in my tummy. Will insurance cover any of the expense due to muscle damage?
Insurance Coverage for Muscle Repair from C-sections Damage?
Doctor Answers 13
Insurance and TT
INSURANCE COVERAGE FOR A TUMMY TUCK
Be well and good luck!
Insurance coverage for muscle repair from c-sections damage?
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!
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Abdominal Wall Hernia
If you have an abdominal wall hernia, then insurance will cover this. But what they wont cover is thightening of the abdominal wall and excision of the skin, i.e. abdominoplasty. You need to see a general surgeon to see if you have a hernia that needs to be fixed.
Hernia or not
Insurance companies will provide coverage for repair of an abdominal wall hernia if one exists. More commonly, however, there is not hernia but a weakness in the abdominal wall called a rectus diastasis. While this may be distressing it posed not health concerns and is therefore not a deformity typically covered by you health insurance provider. As for performing a tummy tuck when an abdominal wall hernia is repaired, this is certainly feasible and often convenient. Its repair, however, does not require that a tummy tuck be performed so don't expect that they will authorize coverage of the tummy tuck. Most likely, you will need to pay out of pocket for the tummy tuck while costs for the repair of a hernia would be covered. If no hernia exists, don't expect your insurance carrier to provide any degree of coverage no matter how damaged the muscles are.
A hard sell
This smells a lot like a tummy tuck, and insurance will smell it too. It of course depends on the medical necessity. This would include hernia etc. Insurance companies are very difficult.
Insurance covers the muscle, not the tummy tuck.
Insurance will cover the muscle repair, but not the tummy tuck. The muscle can be repaired without the tummy tuck, so it is separate and considered cosmetic. And usually the insurance does not pay a lot toward the whole procedure. So look at it as a cosmtic procedure (you pay) with a litle help of the insurance company.
Call your insurance company.
I have not had any success in getting insurance to cover an abdominoplasty. I always repair the muscles that have spread apart from pregnancy. There is a difference between a true hernia and a diastasis recti.
Muscle damage and tummy tuck
Hi, most insurance plans will only cover hernia repairs in the abdomen. They will not cover surgery for any additional removal of fat or skin. You should see a plastic surgeon to clarify the exact procedure you would need to have done, and at that time your insurance company could determine whether or not this would be covered. Good luck, /nsn.
Insurance coverage for abdominal operations
If the muscle damage has resulted in hernias, then insurance should cover this surgery. If you're looking to tighten the muscles and remove some excess skin and fat, then insurance may deny this as being considered a tummy tuck. However, if you do have a hernia and want a cosmetic tummy tuck at the same time, the insurance coverage will help defray some anesthesia and facility fees. Be sure to check out some before and after photos if you do want a tummy tuck to see what results you can expect.
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