I have hernias in the abdominal muscles. Is it reasonable to have a plastic surgeon perform the surgery and also do a Tummy Tuck at the same time? Since the hernia surgery is medically needed, would insurance pay for part of the costs?
March 4, 2016
Answer: Yes hernia surgery is usually covered by the insurance
Most insurance companies will cover the hernia repair procedure. You should start with consultation visit with surgeon of you choice to determine what type of hernia it is. The next step is to pre-certify the procedure with your insurance company. It can be done over the phone or some insurance companies will need a letter for predetermination of that benefit under your plan. Once the procedure is approved by your insurance you can proceed with surgery.
Helpful
March 4, 2016
Answer: Yes hernia surgery is usually covered by the insurance
Most insurance companies will cover the hernia repair procedure. You should start with consultation visit with surgeon of you choice to determine what type of hernia it is. The next step is to pre-certify the procedure with your insurance company. It can be done over the phone or some insurance companies will need a letter for predetermination of that benefit under your plan. Once the procedure is approved by your insurance you can proceed with surgery.
Helpful
November 3, 2015
Answer: Hernia and Tummy Tuck: Insurance considerations
There are two issues here: 1) should the hernia be repaired at the same time and 2) will insurance cover a portion of the procedure. If the hernia is a true umbilical hernia, repairing at the same time as a full tummy tuck may result in compromise of the circulation of the umbilicus. Furthermore, these defects are increasingly being repaired laparascopically or with the use of mesh. In some instances, hospitals do not grant these privileges to plastic surgeons and a general surgeon may be the one who performs the repair and the one who bills for reimbrusement. In regards to reimbursement, most facilities have separate fees and will bill for these individually with pre-payment for the cosmetic portion
Helpful
November 3, 2015
Answer: Hernia and Tummy Tuck: Insurance considerations
There are two issues here: 1) should the hernia be repaired at the same time and 2) will insurance cover a portion of the procedure. If the hernia is a true umbilical hernia, repairing at the same time as a full tummy tuck may result in compromise of the circulation of the umbilicus. Furthermore, these defects are increasingly being repaired laparascopically or with the use of mesh. In some instances, hospitals do not grant these privileges to plastic surgeons and a general surgeon may be the one who performs the repair and the one who bills for reimbrusement. In regards to reimbursement, most facilities have separate fees and will bill for these individually with pre-payment for the cosmetic portion
Helpful