I have recently lost over 100 lbs. My insurance sometimes covers abdominoplasty.

Congrats on your weight loss - that is a great thing ! A tummy tuck procedure is a cosmetic operation. Our clinic will not bill insurance for cosmetic procedures. 

   Insurance may sometimes cover the hanging apron of fat and skin below the belly button.  Procedures can be combined.Kenneth Hughes, MDBeverly Hills, CA

First of all, congratulations on your weight loss!  That is certainly something you should be proud of accomplishing.  Your question is a common one and one that is a bit misunderstood unfortunately. Insurance will NOT cover an abdominoplasty.  What insurance WILL cover is known as a panniculectomy.  It is important to understand the difference between the two.  --An abdominoplasty is a procedure intended to recontour the entire abdomen.  The skin from the lower edge of the rib cage down to the pelvis is elevated, excess is removed, and the remaining skin is tightened to a new contour.  At the same time, the muscles are tightened and a new umbilicus (belly button) is constructed.  This is a purely cosmetic procedure intended to improve the appearance of your body.--A panniculectomy is a procedure intended to remove overhanging skin that is causing a medical condition such as skin rashes, infection, etc.  Only that skin that is overhanging (typically skin below the belly button) is removed.  The muscle is not tightened and the remainder of the abdomen is not addressed.  This procedure is covered by insurance only when it has been documented as a medical necessity.I would recommend that you seek out a consultation with a board certified plastic surgeon to discuss your options and candidacy.  In cases where an insurance-covered surgery is being performed, additional cosmetic surgeries can be performed at the same time.  The added costs of these procedures needs to be determined prior to surgery.  Hope this helps and good luck!

Hello Thank you for your question and congratulations on your weight loss. Typically these surgeries are not covered. However, every insurance company is different state to state. You should check with your insurance company to fully understand. Best regards

Thank you for your questions. And congratulaytions on your weight loss! These are very important things to understand about how this process works. Let me try to clarify some things for you. Insurance never pays for abdominoplasty. What they will occasionally pay for is a panniculectomy. It is important to discern this difference because insurance companies will only cover what they consider to be medically necessary. If a patient has excess skin that hangs down over their pubis and causes medical problems such as rashes, wounds, infections,etc that have required documented medical treatment, then they will sometimes cover the procedure. This procedure only involves removal of the skin that is causing the medical problem, that is, the skin that is hanging past the "waistline" crease. That's it. An abdominoplasty on the other hand involves contouring the entire abdomen, relocating and maintaining the umbilicus, and tightening the abdominal muscles internally.....and all these things are considered cosmetic in nature. So, the short answer is that if you get a "panniculectomy" approved by the insurance, then yes, after all your co-payments and deductibles, it will cover the hospital costs and anesthesia costs. But, do not go online and look at pictures of true abdominoplasties and think that this is what you are getting, because it will not be. If, on the other hand, you do want a full abdominoplasty, additional liposuction, breast lift, or any other cosmetic procedure at the same time, it may be possible to coordinate those along with your insurance procedure, but this will come at an additional cost to you for the surgeon, hospital, anesthesia, etc. You would have to negotiate that cost prior to surgery.I would suggest that you seek a consultation with a board certified plastic surgeon so that you can discuss your case in particular and better understand the differences in the procedures and which one might be right for you and why. In addition, it will help to outline your goals and expectations. When you schedule your visit, you might want to ask them upfront if they are willing to do panniculectomies for insurance, becuase there are many plastics surgeons who are not willing to do this type of work for insurance becaue the reimbursement rates are exceedingly low. Best of luck to you!

Dear Ms, Rajanisha7,Thank you for your story and questions.Congratulations on your weight loss! If I understand your question (rephrased: "will insurance cover the costs to perform a abdominoplasty" I have copied directly from the American Medical Association:(1) Our AMA supports the following definitions of "cosmetic" and "reconstructive" surgery: Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self-esteem. Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance.(2) Our AMA encourages third party payers to use these definitions in determining services eligible for coverage under the plans they offer or administer.(CMS Rep. F, A-89; Reaffirmed: Sunset Report, A-00; Reaffirmed, A-03; Reaffirmed: CMS Rep. 4, A-13).In my experience, unfortunately most insurance companies will not cover what you desire without a physically limiting deformity. However it is always worth a try.Total cost based on:A)what part of the country you have your surgeryB)surgeons feesC)anesthesia fees D)facility feesE) special equipment feesusually costal areas, more experienced surgeons and operations done in a hospital setting are higher in total cost.I suggest you make several appointment with a experienced Plastic Surgeons who are Certified by the American Board of Plastic Surgery and ideally a members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).My best wishes,R. A. Hardesty, MD, FACSDiplomate and Certified by the Am. Bd. of Plastic Surgerywwwimagineplasticsurgery.com4646 Brockton AveRiverside, Ca 92506(951) 686-7600