Will my insurance cover skin removal/tummy tuck surgery - I am a diabetic. (Photo)

Health insurance policies will sometimes cover an abdominal panniculectomy, which means just removing the excess skin hanging low of the abdomen. The criteria to have this coverage are usually stringent and include things like the following:  having lost over 100 pounds of weight, skin extending down to the thighs, recurrent rashes requiring repeated (and documented) antibiotic prescriptions or intravenous antibiotics, attempts at wearing abdominal binders and/or physical therapy. Insurance will not cover an abdominoplasty. I would not expect skin removal to get rid of your diabetes; if the skin removal allows you to be more active, it could perhaps help your diabetes in an indirect way. 

Insurance will sometimes cover a panniculectomy but this is a limited procedure. I would advise a full abdominoplasty. 

Hello and thank-you for your question and photo.A tummy-tuck (abdominoplasty) is considered a cosmetic procedure which is generally not covered by health insurance. This procedure removes excess skin and fat, lifts the pubic area, tightens the muscles, and reshapes the umbilicus (belly button). If you have had a large weight loss and have excess skin which hangs past your pubic area (pannus), health insurance may pay for a portion of the procedure to remove it (panniculectomy). This may lessen some of the cost of the abdominoplasty, but is frequently difficult to have approved by insurance carriers. I would recommend a consultation with a Board Certified Plastic Surgeon. I wish you the best of luck, Andrew Lyos MD, FACS

In general, the answer is no, insurance will typically not apply to abdominoplasty surgeries that are intended to improve the appearance.  However, in specific cases, panniculectomies may be covered by insurance for severe, medically intractable conditions such as infections of an abdominal pannus.  A consultation with a plastic surgeon and a predetermination by your insurance are necessary to determine this.

Thank you for sharing your question.  Unfortunately surgery will not cure your diabetes, only weight loss can hope to do that.  It is possible to remove some of the overhanging skin in a procedure termed a panniculectomy so as to avoid skin rashes and infection.  This is at times covered by insurance.  Hope this helps.

Hi, plastic surgery in general are not covered my insurance, TT included. If you are still willing to get into surgery I recommend you to consult a certified plastic surgeon and coordinate with him or her which procedures will fit your needs.
Regards

Dr. Israel Mañon                                                     

Certified Plastic Surgeon

Thank you for the question.
The tummy tuck operation will serve to remove “excess” skin/subcutaneous tissues and “repair” abdominal wall muscles that have spread with pregnancy and/or weight gain/loss. The operation should not be expected to help with treatment or control of diabetes.
Well controlled diabetes is not a contraindication to tummy tuck surgery and/or other elective plastic surgical procedures.  However, diabetics are at a greater risk of infection compared to non-diabetic patients. Always best to check with your primary care physician or endocrinologist for “medical clearance” prior to surgery. Managing your diabetic medications around the time of surgery (to avoid hypo as well as hyperglycemia), while you will have altered oral intake, will be important.I would not expect insurance companies to cover the procedure.  Best wishes.

Tummy tucks are typically NOT covered by insurance. However, a panniculectomy may be covered in some cases. See a local plastic surgeon for an assessment.

Thanks for the question.  Based on your photo, it appears that an abdominoplasty is not the appropriate operation for you.  You may qualify for a panniculectomy, but you will certainly need to be evaluated by a board certified plastic surgeon.  Insurance qualification is based on several factors which may include BMI, stable weight, how low does your skin hang, repeated skin rashes, etc.  This procedure is considered “functional” rather than cosmetic and the umbilicus is typically not spared.  At your weight and with diabetes, your are likely at a higher risk for wound healing complications and possibly other issues, so I would advise medical clearance for the procedure and again, a thorough examination and consultation with your plastic surgeon. Beat of luck.

An abdominoplasty would definitely help to relieve the skin rash, because it would remove the skin and fat. However,  The tummy tuck will not cure your diabetes. I would suggest seeing a board-certified plastic surgeon in your area and talking to your insurance company. Ultimately that question can only be answered by the insurance company. Best of luck!