Do some insurances cover surgery to fix diastasis recti? If I get a tummy tuck would it fix this problem?

Question

i think I have Diastasis Recti. I’ve had two kids. The lower part of my stomach is heavy and hangs. I started to excersice but I think it made things worse cause that’s when I started to get severe lower back pain/stomach pain.its very hard to move around,get up from sitting or laying. I also have siatica so it makes things worse. Questions are,if I get a tummy tuck would it fix this problem? And would insurance cover the procedure? And if not what are my other payment options?

Reza Rod, MD · Answer

Your first step is to call your insurance company.  Ask if you have a benefit and if so what board certified plastic surgeon is within your network. Document your problem with your provider because you'll have to prove that this is a medical necessity.  It's complicated to get these approved with insurance but you don't even want to start until you know you've got the right insurance benefits.

Jonathan Hall, MD · Answer

Our insurance companies in Massachusetts do not cover the repair of a diastasis rectus, which is caused by the pregnancy ( or severe weight gain) pushing the rectus muscles apart. Most insurance companies will cover the repair of a hernia at the time of an abdominoplasty so your board certified plastic surgeon will usually check for this during your exam.  Some insurance companies will cover the panniculectomy portion of an abdominoplasty if the skin hanging down is severe and causing chronic rashes.  But a panniculectomy alone only removes the extra skin that hangs down and does not correct the muscle wall looseness- it is not an aesthetic procedure and is usually only done by itself in severe cases when patients are having significant rashes.

Emily J. Kirby, MD · Answer

That would be great, wouldn't it?! Unfortunately, insurance does not cover this procedure. Some insurance companies will cover panniculectomy if you meet their medical criteria, but keep in mind this is NOT the same as a tummy tuck, or abdominoplasty. In a panniculectomy, the muscles are not tightened to fix the diastasis. Also, in a true panniculectomy covered by insurance, you risk losing your belly button, as insurance does not cover the portion of the procedure performed to keep it in place. Be sure to discuss the details with your board certified plastic surgeon before deciding what is right for you.

Arnold S. Breitbart, MD, FACS · Answer

The hanging of your lower abdomen may be more due to skin excess.  You may also have diastasis recti, which is a separation of the rectus muscles which can occur after pregancy and cause bulging.  Insurance companies generally do not cover tummy tucks, including when there is diastasis recti.

Charles R. Nathan, MD, FACS · Answer

Muscle separation from pregnancy can contribute to bulging of the abdomen and can sometimes be associated with lower back pain due to a weak core.  Traditional core exercises can sometimes make it worse.  Seek core exercises for women with diathasis to try to improve your core.  Insurance does not typically cover tummy tucks or muscle repair.  The only time insurance may cover is if there is a true hernia, not a diathesis.

Do some insurances cover surgery to fix diastasis recti? If I get a tummy tuck would it fix this problem?

Answers (6)

Answer: Tummy Tuck and Diastasis Recti

Answer: Tummy Tuck and Diastasis Recti

Answer: Insurance coverage for diastasis.

Answer: Insurance coverage for diastasis.

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Do some insurances cover surgery to fix diastasis recti? If I get a tummy tuck would it fix this problem?

Answers (6)

Answer: Tummy Tuck and Diastasis Recti

Answer: Tummy Tuck and Diastasis Recti

Answer: Insurance coverage for diastasis.

Answer: Insurance coverage for diastasis.

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Recommended reading

Everything you need to know about Tummy Tuck

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