Will Insurance Possibly Cover a Scar Revision?

I am a 46 yr old mom of 3 children, all 3 c sections. Around the age of 31, I had my stomach stapled for weight loss. After loosing aprox 150 lbs, I had a panniculectomy. This resulted in the loss of my belly button, 154 staples and a huge scar from hip to hip & up to the breast area. A doctor that I previoulsy worked with felt it was a sloppy job & more skin should have been cut from the pelvic area & lifted. Now I have pain continuously from the pubic area being so large & heavy.

Doctor Answers 5

Insurance companies will pay for a scar revision.

It sounds like you would benefit from both a scar revision and revision of the panniculectomy/tummy tuck. A panniculectomy removes the extra hanging skin around the pubic region. When excessive skin in the pubic region is large, heavy, and very uncomfortable, it leads to medical problems. Most insurance companies will cover surgeries for medical reasons. Of course, the only way to truly assess your needs would be with an in office consultation. Your surgeon should help you by submitting your information to your insurance company for approval. 

Long Island Plastic Surgeon
5.0 out of 5 stars 4 reviews

Insurance and scar revision.

Each insurance is different. You need to call your insurance carrier. There is no rhyme or reason as to why insurance companies cover one thing but not another.

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.3 out of 5 stars 34 reviews

Scar revision following panniculectomy

Typically, you would need documented problems that are causing you significant functional issues.  An evaluation of your symptoms along with examination of your concerns is warranted.  While insurance companies will make the ultimate decision as tho whether they will authorize your surgical procedure, your surgeon could only document your stated complaints as well as physical signs that s/he sees during the examination along with photographs.  It is worth exploring with the option of scar revision as a cosmetic procedure always there.  Hope that this helps!  Best of luck! 

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

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Insurance coverage for tummy tuck scar

Insurance companies apply a standard of functional necessity to scar revision so, if the scar does interfere with your activities of daily living, the case can be submitted for preauthorization.  If your initial surgery was covered by insurance, then there is a possibility that the secondary procedure would be covered as a complication.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
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Insurance for a painful scar

It would be rare if scars were covered by insurance for "pain."  All you can do is to save up for a revision if your doctor can't get you covered.  Don't expect to be getting covered so if you are you will be pleasantly surprised.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

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.