Fighting Insurance Company for Tummy Tuck

They may help cover some of the costs if you meet their criteria.  Often this means repeated doctor visits for skin rashes or breakdown.  You can learn all about this process on my website under "Patient Resources."

Unfortunately, insurance does not cover a tummy tuck. Occasionally with documentation of recurrent infection they will pay for a panniculectomy (simply removing loose skin).#tt#tummytuck

I have not been successful in convincing an insurance company about the validity of the medical necessity for a  tummy tuck. However, muscle tightening is not a valid concern for them. Therefore it is best to not bring this up. Generally speaking the skin unlceration and redness my be your best approach.

If you are basing your rationale for an abdominoplasty on 'image issues' there is no conceivable way an insurance company will pay for that operation. In fact, the 'code' for abdominoplasty which surgeons have historically used to 'bill' an insurance company for this procedure no longer exists. Save your energy and quit fighting with your insurance company over this issue. Seek out a board certified plastic surgeon that will work with you on procedure pricing. Alternatively, look into the 'resident's clinics' at the local university medical center's (UVA?) plastic surgery training programs. You may be able to get your tummy tuck at a substantial cost savings and have it performed with a team of supervised plastic surgery trainees.

We wish you luck in your fight. But the reality is this insurance company, Optima, and MOST others deem cosmetic image surgeon a non covered benefit. That is the way it is. So either start saving or go to a University dept of Plastic Surgery for resident in training surgery at very reduced fees. Best of luck on the last 30 pounds!

From MIAMI DR. B