Will Insurance Possibly Cover a Scar Revision?

Question

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.

Lewis Albert Andres, MD · Answer

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!

Raj S. Ambay, MD · Answer

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.

Robert L. Kraft, MD, FACS · Answer

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.

Steven M. Katz, MD (retired) · Answer

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.

Richard P. Rand, MD, FACS (retired) · Answer

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.

Will Insurance Possibly Cover a Scar Revision?

Answers (5)

Answer: Insurance companies will pay for a scar revision.

Answer: Insurance companies will pay for a scar revision.

Answer: Insurance for a painful scar

Answer: Insurance for a painful scar

Recommended reading

Everything you need to know about Panniculectomy

Our mission is to create a world where every investment in modern beauty is Worth It.

Will Insurance Possibly Cover a Scar Revision?

Answers (5)

Answer: Insurance companies will pay for a scar revision.

Answer: Insurance companies will pay for a scar revision.

Answer: Insurance for a painful scar

Answer: Insurance for a painful scar

Browse related questions

Recommended reading

Everything you need to know about Panniculectomy

Our mission is to create a world where every investment in modern beauty is Worth It.