Will Medicaid pay for tummy tuck under medically necessary plastic surgery and not cosmetic? (photo)

Question

I had multiple fibro tumors on my uterus that grew into a very large mass I had to have surgery because of the size the Dr. cut me straight down vertically to removed my uterus and now I have a big stomach and all this excessive skin after surgery.

Deborah Sillins, MD · Answer

A tummy tuck is considered cosmetic surgery. No form of insurance will cover a cosmetic surgical procedure. If you wish to go forward with your surgery make sure you see a board certified Plastic Surgeon.

Lawrence Iteld, MD · Answer

By definition, a tummy tuck is a cosmetic procedure whereby liposuction, muscle tightening, and skin excision is performed with the goal of achieving the flattest, most contoured, shape possible. This procedure is not covered by insurance. A panniculectomy is a procedure where the hanging (and only the hanging) lower tummy skin is removed. Insurance coverage varies and medical necessity must be demonstrated. These requirements vary by carrier. If you want to persue this Avenue, please see a surgeon who accepts your insurance for an assessment.

Niki Christopoulos, MD, FACS · Answer

Hi and thank you for your question and picture.  Unfortunately, no, insurance (including medicare/medicaid) do not cover abdominoplasty procedures.  These are considered cosmetic and not medically necessary.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Unfortunately Medicaid will not cover the cost of a tummy tuck as they deem it "not medically necessary" in nearly all cases.  I would recommend seeing a plastic surgeon in consultation after you are healed from your hysterectomy to see what treatment options do exist for you to be able to reduce the amount of excess skin present.  Hope this helps.

Jimmy C. Sung, MD · Answer

Thank  you for your post. Medicaid will not pay for a tummy tuck. Most insurance will not cover a tummy tuck because this is a cosmetic procedure and not a necessity. Some insurance companies may, however, cover a  panniculectomy. Both of these procedures are different and you will not get the same results as a tummy tuck with a panniculectomy. A panniculectomy will just remove the hanging skin. When a tummy tuck is done we are tightening the muscles and also combining the procedure with liposuction to give the body a better contour. I would set up a consultation with a board certified plastic surgeon to review your options and answer any questions that you may have.

James A. Hoffman, MD · Answer

No, insurance will not cover a Tummy Tuck but removal of excess lower abdominal skin can be covered when done by a general surgeon as a Panniculectomy. This would be something you would likely have to pursue with a referral from your primary doctor.

Karol A. Gutowski, MD, FACS · Answer

Medicaid will not pay for a tummy tuck but may pay for a panniculectomy, which is a removal of some of the loose skin. However, is most cases, a panniculectomy does not give significant results.

Sarah W. Holland, MD · Answer

In general, medical insurance does not cover tummy tucks, but there are some other procedures that may help, including panniculectomy which is often a covered procedure. I would recommend a plastic surgery consultation to identify the details of the problem and the medical necessity of having surgical treatment. Best of luck to you!

Will Medicaid pay for tummy tuck under medically necessary plastic surgery and not cosmetic? (photo)

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Answers (8)

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