Infected C-section Scar Covered By Insurance?

Question

I had a total of 3 csections, the last one I ended up with a deep sunken scar that is itrtiated and infected all the time. My stomach sticks out and skin hangs over the scar causing even more issues. Wouldn't this be covered by insurance?

Mahlon Kerr, MD, FACS · Answer

My experience has been that most folks need a tummy tuck in your situation.  Its possible that your insurance may cover a small portion of the fees for the scar revision.  Without an examination its impossible to give much useful advice besides that I would find a PS on your insurance plan and visit with them.

Jeffrey E. Schreiber, MD, FACS · Answer

It's hard to say without seeing you and sending in photos to your insurance company.  However, it sounds like this is something that can get covered if you're having chronic infections.

Louis C. Cutolo, Jr., MD, FACS · Answer

Probably not.   Insurances will provide coverage for procedures that are done in order to improve function.  Although we don't have pictures to judge, it sounds like you have a poorly healing scar with some abdominal skin overhang. One might argue to the insurance company that the poorly healed scar " is not normal" and a revision should be covered.  They will probably consider it "cosmetic" since there is no functional deficit involved. I believe that the same is true with the excess abdominal skin as well.  You can always contact your insurance company so that they can make a direct determination....but more often that not - the procedure will not be covered.

David Finkle, MD · Answer

Health insurance coverage for elective procedures will need to be pre authorized in writing by a physician.Insurance companies have become very difficult to work with and will not OK a tummy tuck for this type of problem, but may OK a scar revision if you can prove chronic infections.  A scar revision would consist of removing the depressed scar and "re-arranging" the surrounding skin to prevent further problems.  This should be a quick outpatient procedure with a rapid recovery.

Jourdan Gottlieb, MD · Answer

A scar revision might well be a covered procedure given the info in this posting. What would not likely be covered is an abdominoplasty to treat the protruding abdomen or  the overhanging skin. All the best.

Infected C-section Scar Covered By Insurance?

Answers (7)

Answer: Insurance coverage for scar revision

Answer: Insurance coverage for scar revision

Answer: Infected C-section Scar Covered By Insurance?

Answer: Infected C-section Scar Covered By Insurance?

Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.

Infected C-section Scar Covered By Insurance?

Answers (7)

Answer: Insurance coverage for scar revision

Answer: Insurance coverage for scar revision

Answer: Infected C-section Scar Covered By Insurance?

Answer: Infected C-section Scar Covered By Insurance?

Browse related questions

Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.