Will Insurace Cover Tummy Tuck to Fix Painful Rashes?

A tummy tuck is a cosmetic procedure to remove excess skin and repair the stretched out anterior abdominal wall muscles. I personally also do liposuction of the upper abdomen, flanks, hips, upper buttocks and back to achieve the best shape. A panniculectomy is done to get rid of the excess skin overhang and stop skin rubbing on skin which results in the medical problems you are experiencing. This might be covered by your insurance. If that is what you are interested in, I would refer you to a general surgeon. I do not do panniculectomies in my practice, they do not look pleasing, but will solve your skin issues. You do not state your height and weight, other medical problems you might have and it is possible that you are not a candidate for a tummy tuck.
web reference: www.bellevueplasticsurgeons.com

Occasionally, insurance covers excision of excess skin when rashes occur under the overhang of tissue. Documentation by a family doctor over a period of a year is usually necessary. Various treatments also need to be documented. I have seen patients who have undergone gastric bypass and their abdominal lipectomy is covered for similar reasons. Most of the time, it depends on the insurance company.

 It really depends on your specific case and your insurance, so I would recommend having an exam and seeing what your plastic surgeon thinks. Some insurance carriers are stricter than others, and they may want photos, etc. before they will agree to pay for it.

In most cases, insurance will not cover a tummy tuck or abdominoplasty. This is the medical terminology for a cosmetic procedure. However, in some cases, insurance companies will cover a panniculectomy, which is similar to a tummy tuck but is done for medical reasons. In most cases, the reasons are massive weight loss, chronic sores, etc. This procedure typically just involves removing the excess skin, but does not involve tightening the muscles.

In rare circumstances, including a documented history of rashes and wounds, an insurance company may cover a procedure called a panniculectomy. This is a wedge excision of overhanging skin. It's important to realize that this is a functional operation, not a cosmetic one, and the results are not comparable to a tummy. In a tummy tuck, the skin is removed and the muscle is tightened to try to obtain a flat, pleasing contour of the abdominal wall. In a panniculectomy, extra skin and fat is wedged off; nothing else.
Not all insurance companies cover this procedure - some have specific exclusion criteria. It's best to contact your insurance carrier to see if this is a covered benefit. If it is, start with your primary care physician to see if conservative management is effective in healing your wounds and cuts. If it is not, then your insurance carrier may consider paying for a panniculectomy. Again, though, do not expect results that are comparable to a tummy tuck.
Best of luck.