Under what conditions would my insurance company cover a tummy tuck?

Question

Under what conditions would my insurance company cover a tummy tuck? (I have major scar tissue after a c section that wasnt performed properly) if so what doctor would do the procedure?

Mariam Awada, MD, FACS · Answer

Hello.  Insurance does not cover cosmetic procedures such as tummy tuck.  If you are concerned about your scar your insurance may cover a scar revision.  At your consultation of a tummy tuck is the right procedure for you, you will be provided an exact quote and be able to determine how to proceed.

Nelson Castillo, MD · Answer

Thank you for your question.  It sounds as if you have suffered a tethered C-section incision, where scar tissue has pulled your scar down to the muscles of your lower abdomen.  In this case your insurance company may cover what's termed a "scar revision."  Tummy tucks are cosmetic procedures designed to remove excess skin and adipose tissue of the abdomen while also tightening the stomach muscles.  These tummy tucks are considered cosmetic and not covered by insurance. Hope that this helps.

Charles Galanis, MD · Answer

In the situation you described you may be able to get insurance to cover a scar revision.  However, a tummy tuck is a much more involved procedure which entails resecting excess skin, tightening the muscle, recreating an umbilicus, and recontouring the entire abdomen. This is almost never covered by insurance as it is an elective cosmetic procedure.

Kenneth Hughes, MD · Answer

Insurance may cover a scar revision for the C-section scar, but it will not cover a tummy tuck.Kenneth Hughes, MDBeverly Hills, CA

Francis Johns, MD · Answer

Thank you for your question.There is no situation where an insurance company will pay for a cosmetic tummy tuck.  Some insurance companies will pay for a Panniculectomy, which is removal of the excess hanging skin of the abdomen. A panniculectomy is usually performed after extreme weight loss and there are strict requirements that need to be met in order for it to be covered by the insurance.

Ryan T. M. Mitchell, MD, FRCSC, FACS · Answer

Unfortunately insurance providers do not participate with abdominal contour improvement procedures. At best, you may get partial coverage for a scar revision of the abdomen if there are some functional issues related to the tethering of the scar. In order to get the rest of the contour improvement you are looking for there would be an associated out-of-pocket expense.

Carlos Burnett, MD, FACS · Answer

Insurance  does not cover elective surgical procedures under any circumstances. If there is a clinical indication for surgery for medically necessary reasons your company may cover  a portion of the cost for that condition. An unsightly scar is not  considered to be a medically necessary condition. A TT is not covered by insurance.

Jourdan Gottlieb, MD · Answer

Insurance coverage for a tummy tuck almost never happens. This is a cosmetic procedure, and the insurance carriers are well aware.If there is a medical issue with the healing of your c-section scar, it is possible, though not necessarily likely, that you might have coverage for a scar revision.Best wishes.

Sugene Kim, MD, FACS · Answer

Hi, Tcobb41.Tummy tuck is an elective, cosmetic procedure.  Insurance company will not cover for the procedure.However, if you have hypertrophic scar, hernia, or pannus that causes medical condition may be covered depending on your policy.Please consult a board-certified plastic surgeon to be evaluated in-person.Best regards.

Patrick L. Basile, MD · Answer

The short answer is no, but I have seen some insurance companies cover scar revision for c-sections if they meet criteria. What that criteria is varies from company to company. I would read the policies and coverage of your plan and see what they cover. As always I recommend a board certified plastic surgeon to perform the procedure. Best of luck!

Under what conditions would my insurance company cover a tummy tuck?

Answers (10)

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