Will insurance cover a revision of a tummy tuck?

Question

So I have been in almost constant pain since tummy tuck, went to hernia specialist in L.A. referred back to plastic surgeon for repair of weakness, opening in fascia. Fat to right of navel, and area to stitch, will Blue Cross Blue Shield cover this ?

Robert M. Lowen, MD · Answer

All insurance companies classify abdominoplasties (tummy tuck) as not medically necessary.  So they do not cover them. However, insurance is supposed to cover treatment of painful conditions and hernias. For example, when a woman has a painful capsular contracture after breast augmentation, insurance may cover this, and in my experience, they always do. 
If your doctors can document that you have a painful condition, associated with an abdominal wall hernia, it would be reasonable to request insurance coverage and get prior authorization if possible.The coverage would be for the approach to, the repair of, and closure of the opening access incision. It would not cover any associated cosmetic revision.  Generally, when there is a combination of insurance and non-insurance aspects to a procedure, not uncommon in breast and nose procedures, the facility and anesthesia times are recorded for each segment, cosmetic and non-cosmetic, of the procedures, and charges are allocated accordingly.

Daniel Barrett, MD · Answer

Dear anon849202,it is unlikely that insurance will cover tummy tuck or tummy tuck revision surgery. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Johnson C. Lee, MD · Answer

Insurance companies will not cover cosmetic procedures or revisions of cosmetic procedures. In some cases of medical necessity or emergency, they may provide coverage however it is not a guarantee. The best way to know is to for you or your doctor's office to contact your insurance carrier directly and speak with them to see if your procedure is covered by your policy. Hope this helps! Johnson C. Lee, MD
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

Tim Sayed, MD, MBA, FACS · Answer

It is unlikely any insurance carrier will cover revision of a cosmetic abdominoplasty surgery. Speak with your surgeon's office regarding costs for revision surgery.

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