Wanted to know if I could get a tummy tuck with Blue Cross Blue Shield insurance?

A tummy tuck is considered a cosmetic procedure so insurance doesn’t typically cover it. However, there are rare cases that coverage is possible if the procedure resolves health issues. It’s best to contact your provider to find out, then work with your surgeon to obtain coverage.

 Tummy tuck surgery is considered elective and not medically necessary, unless you have some problems with rashes or other medical problems you probably will not get any insurance reimbursements.

Although cosmetic procedures are never covered by insurance, certain procedures related to your surgery may be covered by certain insurance carriers. Photos would be helpful to determine if you require a TT or a panniculectomy which might be covered.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Insurance does not traditionally cover elective cosmetic procedures. There are exceptions when medical necessity can be proven. With regards to abdominal contouring, excision of a symptomatic hanging pannus can be covered for issues of recurrent rash and skin breakdown. However, this is not a tummy tuck and involves limited skin excision, no muscle plication and no umbilical incision.As always, discuss your concerns with a board certified plastic surgeon (ABPS).Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic
Surgery, American Society of Plastic Surgeons
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A tummy tuck is considered elective cosmetic surgery and is therefore not covered under insurance.  If you are interested in learning more about the procedure and its benefits we welcome you to visit us in our Houston office for a consultation.

Hello, and thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) Abdominal panniculectomies which are medically necessary (e.g., if you have rashes or skin breakdown under your abdominal fold) are covered by most medical insurance providers. Occasionally medical insurance providers may try to deny you based upon a lack of symptoms, lack of previous medical management, and/or lack of enough tissue to be removed. Read your medical insurance certificate of coverage. Determine what medical information is required for your medical insurance provider to issue a pre-authorization or predetermination of benefits for the panniuclectomy. Then, gather that information, and schedule a consult with a plastic surgeon.
If you decide to pursue surgery it’s very important that you find a surgeon whom you are comfortable with and trust and who evaluates you in-person, addresses your concerns, and tailors an individualized treatment plan for you and your aesthetic goals. Best of luck!
Matthew A. DelMauro, M.D.

Unless there is some unusual circumstance, insurance companies generally do not cover tummy tuck surgery. In other words, insurance companies do not consider this operation medically necessary. Sometimes, however insurance companies will cover excision of lower abdominal wall skin/apron; this operation is called a panniculectomy.The panniculectomy operation involves excision of the lower abdominal wall pannus or  overhanging skin/adipose tissue. It is not considered an  aesthetically driven procedure;  it is often performed to help with concerns such as skin breakdown, infections/rashes…  Best wishes.