Will medicare pay for a tummy tuck if you show that you have medical problems?

Question

Reza Rod, MD · Answer

My advice to you is this....Don't ask about a tummy tuck because no insurance will cover it.  Ask if your insurance will cover a Panniculectomy (the insurance version of a TT).  Now have your primary card doctor document your problems with your excess skin.  Do you have fungal infections within your excess skin, back problems, or other issues?  Essentially, you need your Panniculectomy to be a medical necessity.  If it truly is needed, there's hope for you.These procedures are hard to get covered for many reasons.  Insurance companies need documentation which will mean your doctor will have to take pictures, do a pear-to-pear review, and you need one of the few plastic surgeons that accepts your insurance.  Also your insurance needs to have a benefit for it.As you can see.... it's not easy but not impossible either. Even if your insurance covers it, it might not cover all of the expenses so just be prepared for this. Call you insurance company and ask for a list of plastic surgeons in network with your insurance that are in your area.  This is an important step to get you started.  I wish you luck!

Alain Polynice, MD · Answer

The short answer is no because a tummy tuck is considered a cosmetic procedure. There are cases where people have lost a significant amount of weight and have a large apron of skin hanging over the pubic area.. these patients with medical problems related to weight loss could qualify for a panniculectomy which is a medically indicated procedure and very different from a tummy tuck. I would recommend you get a consultation with a board certified plastic surgeon who can determine which type of procedure would suit you best
Wishing you all the best
Alain Polynice, MD, FACS
New York Board Certified Plastic Surgeon

Susan Buenaventura, MD, FACS · Answer

A tummy tuck is a cosmetic procedure.  Medicare will not cover it.  Your surgeon can be accused of medicare fraud if she/he submits a cosmetic procedure for reimbursement.  Sometimes panniculectomy can be covered, but that is a different surgery.

Will medicare pay for a tummy tuck if you show that you have medical problems?

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Will medicare pay for a tummy tuck if you show that you have medical problems?

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Everything you need to know about Tummy Tuck

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