Will Medicaid pay for tummy tuck due to back problems? No air under my stomach, get rashes, obesity, medical problems (photo)

Question

Been having problems where stomach is too heavy I've had 2 c -sections Nd hysterectomy Nd Tha lose flab need removed

Erik Miles, MD, FACS · Answer

Insurance companies, as well as Medicare and Medicaid, consider a tummy tuck a cosmetic procedure.  it is therefore not a covered benefit,  even in patients who would have improvements to certain medical conditions.  There is a procedure called a panniculectomy which involves removing only the lower overhanging abdominal skin.  This is covered  on rare occasion, however very strict criteria have to be met and most plastic surgeons do not perform those procedures through an insurance.  In fact most plastic surgeons do not except Medicaid. The reason is that the reimbursements are extremely low for the amount of work involved.  It is also very challenging to obtain payment  after a procedure such as a panniculectomy and requires a huge investment of time from their staff.   Most offices have payment plan options that you can look into. My advice would be to seek a consultation from a board-certified plastic surgeon to discuss your options. Best wishes to you!

Janet Turkle, MD · Answer

Hi,In general, no insurance, including Medicaid, pays for cosmetic procedures. You may be able to obtain coverage for medical reasons for a panniculectomy, which is removal of the hanging "apron" of tissue from your abdomen. However, that determination of medical necessity has to be made by Medicaid in your state. Call Medicaid and speak with them. Good luck.

Thomas Trevisani, MD · Answer

Probably not. Best to check with the Medicaid office for the definitive answer. If they pay- it will be paid for by tax payer's dollars and the amount will be significantly below the standard fees for this operation. Even though you may have a significant medical benefit from this procedure- it is essentially - a Cosmetic Operation, which is usually NOT covered by any type of insurance policy. I suggest you modify your diet and exercise and try your best to achieve your goal through a lifestyle change.

Frederick G. Weniger, MD, FACS, MBA · Answer

Insurance typically does not pay for cosmetic surgery. However, you can check with your insurance company. Tummy tucks are performed for cosmetic/elective reasons. To lessen the back issues you are having would be best achieved by making a lifestyle change, dieting, and exercising.

Will Medicaid pay for tummy tuck due to back problems? No air under my stomach, get rashes, obesity, medical problems (photo)

Answers (4)

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