If I have abdominal muscle separation, as a result of numerous surgeries will my Aetna choice 2 plan cover a tummy tuck? (photo)

Two C-sections , A partial hysterectomy, my left ovary removed and four other female reproductive organ surgeries. One end of my scar opened up after the hysterectomy 16 years ago. The doctor told me it would heal from the inside however I can still push your finger deep into the opening , it's healed but it feels like a hole under my skin. I've been told by numerous trainers that I have abdominal muscle separation . Will my insurance cover any part of a tummy tuck ?

Doctor Answers 2

Tummy Tuck and Insurance

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Insurance will typically not cover any cosmetic procedure and a tummy tuck is considered as such. Insurance will cover a repair of an abdominal hernia or a panniculectomy for documented infections to the abdominal redundant tissue at the waist called a pannus. I would not base any decision on your situation from observations a personal trainer since they had no formal medical training. The best option would be to be evaluated by a board certified physician who can address your anatomy and give you options. Good Luck and continue the exercise-way to go.

Insurance Coverage of Tummy Tuck

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Your frustration is common to many women. Cosmetic surgery is defined as surgery which improves appearance. A Tummy Tuck is a cosmetic operation because muscle separation is NOT a hernia ( defined as the protrusion of anatomical structures beyond their normal location into a structure where them it/they do not belong).

Medical insurance companies do not pay for cosmetic surgery and restrict coverage of some non-cosmetic operations. Although most will partially pay for the repair of a Hernia, especially if it is well documented, they will never knowingly will pay for the repair of muscle separation which is the consequence of pregnancy and massive obesity. 

Peter A. Aldea MD
Memphis, TN 

Peter A. Aldea, MD
Memphis Plastic Surgeon

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.