I was wondering if my medical card would pay to fix my hernia and cut extra skin off?

I have terrible, deep stretch marks on my belly all the way up past my belly button. I have ALOT of extra skin! I also have a up an down c-section scar. And i have a hernia by my belly button. It hurts so, so bad! It feels like all the extra skin on my belly pulls on my hernia! It hurts when I wear jeans. Sometimes I just sit an cry! I was wondering if my medical card ( MD physicians care ) would pay to get the hernia fixed an cut off my extra skin?

Doctor Answers 7

Tummy tuck plus hernia

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I would gop see a plastic surgeon and he may have to write to your insurance company to see if they will pay for this.They should at least pay for the hernia repair.

Fort Myers Plastic Surgeon
4.9 out of 5 stars 70 reviews

I was wondering if my medical card would pay to fix my hernia and cut extra skin off?

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Hernia repairs are covered by insurance. Removal of excess skin and stretch marks is cosmetic and not covered by insurance.

Janet Woodyard, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 18 reviews

Hernia? and excess skin

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In recent  years, insurance companies will only pay for true hernias. If you have a diastasis. that is, a separation of the rectus muscles, the insurance companies will not pay for this. Even in a very significant diastasis, it will be denied. Unfortunately, excision of excess skin of the lower abdomen is not considered a medical problem and will not be paid  by  insurance.

It's very important that you are examined by a PS to make the diagnosis of hernia rather than a diastasis. Good luck.

Insurance coverage

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You primary insurance may provide some coverage to an in-network provider for the hernia repair. The removal of excessive skin is not considered medically necessary and would not be covered. 

Tummy Tuck and Hernia Repair

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Thank you for the question. Sorry to hear you are having pain. The hernia repair should be covered by your insurance company but, unfortunately, the skin excess typically is not. I commonly repair the hernia at the time of the tummy tuck surgery. It is best to see a board certified plastic surgeon who commonly performs this procedure. I hope this helps and good luck!


Extra skin

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Hernia should be  covered by insurance. Removal of the extra skin would not. I do not think the insurance companies would find a connection between the two. Certainly fixing the hernia at the time of abdominoplasty would be very appropriate. Best of luck to you. 

Hernia Repair is Usually Covered, Tummy Tuck is Usually Not.

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I am sorry that you are having symptoms.  Those symptoms may press you to get something done. 

Hernias are typically considered a covered service.  
Tummy Tucks typically are not covered and considered cosmetic, but many patients find great satisfaction and relief by saving the money to pay for the surgery.  

If you have both a hernia and excess skin, your plastic surgeon may be able to fix both and discount your tummy tuck fee and accept what the insurance allows for the hernia.   
The tummy tuck won't be 'free', but you may be able to get it done at a reduced cost to you. 

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.