Is a Tummy Tuck Ever Considered Medical?

I have had overlying skin on my lower abs since I was quite young due to the loss of weight. I then had two c-sections, hysterecotomy and the fat just increased. I now have lumbar lordosis, spinal stenosis and degenerative disc disease. Also asteoarthritis and fibromyalgia. Is a tummy tuck ever considered medical?

Doctor Answers 7

Insurance coverage for abdominoplasty

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Thanks for the question -

In our San Francisco practice we've done a fair number of abdominoplasties. It is unusual for companies to cover a true abdominoplasty.

Many insurers will cover massive weight loss patients for panniculectomies (removing the abdominal pannus). The theory here being that patients with skin down to their knees have significant mobility and hygiene problems.

We have had insurance companies cover abdominoplasty for significant abdominal scars but it is a rarity.

I hope this helps.

No, but it might help you very much

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It sounds as though a tummy tuck might be very valuable and make your abdomen much better. The muscle tightening might help your back a little bit. You have enough anatomical problems in your back plus other conditions that you might not feel much different though. Don't expect that insurance will cover any of this.

Insurance and TT

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

Tummy tucks and insurance

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A tummy tuck is almost never covered by insurance. Insurance companies sometimes cover a panniculectomy for massive weight loss patients.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Tummy tucks are rarely considered medically necessary

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Tummy tucks are a popular and effective way to recontour the abdomen. They may be commonly combined with other procedures that are considered medically necessary such as gynecologic surgery or hernia repairs. By themselves, however, tummy tucks are not medically necessary. If you have an excess amount of skin in your abdomen and our experiencing pain or rashes from this skin, you may benefit from a panniculectomy. This is an excision of the skin without a deeper muscle repair.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

Medical necessity letter for Tummy Tuck

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It is very hard to get insurance approval for an abdominoplasty. However, I would recommend that you try with your insurance company. Your letter to them must be supported with all the medical reports indicating the medical need for a tummy tuck.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Tummy Tuck and Insurance

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There are many procedures that, while covered in the past, are no longer covered benefits under current insurance plans.

Scar revisions, skin rashes/ulcers/breakdown, may be covered under more generous plans but this is a rare event today.

Occasionally, associated hernias may be considered a covered procedure.

If you work for a large employer, you may carry more clout with your insurance carrier through your human resource department.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

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.