I have an umbilical hernia and diastasis recti. Will insurance cover the repair of both?

3 months ago I had nausea and pain along the linea alba. My gallbladder was removed. I still have nausea and pain especially while sitting. Laying down helps relieve the pain and nausea. I have had blood work, endoscopy, colonoscopy, and 3 CTs (chest, abdomen, pelvis). The only thing that has been found is a small umbilical hernia and diastasis recti. I am 6' 1" and 183. My stomach looks distended and uncomfortable since the surgery. Will insurance cover the hernia and diastasis repair?

Doctor Answers 7

Simultaneous umbilical hernia and diastasis recti

It is certainly possible to repair both at the same sitting which obviously makes sense both physically and economically. Although some doctors may consider diastasis rectify to be a form of hernia it is not a true hernia so would not normally be  covered but you might be able to ask to check.

Alternatively you may be able to contribute a sum to cover the excess  for the additional procedure without having to fund the full cost.

Best of luck.


London Plastic Surgeon
5.0 out of 5 stars 4 reviews

I have an umbilical hernia and diastasis recti. Will insurance cover the repair of both?

Most insurance companies will cover the cost of the hernia repair, but not the diastasis. Your physician can submit an insurance predetermination to make sure. The rectus diastasis may be repaired simultaneously so you have an improved appearance with only one surgery and recovery. 

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 12 reviews

It all depends on your insurance

Insurance contracts vary from contract to contract. Some insurances will cover symptomatic umbilical hernia. None will cover repair of diastasic since it is not a medical issue.  

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 21 reviews

Will insurance cover diastasis.

This is a very common question and while insurance will cover repair of your umbilical hernia they will not cover diastasis of the muscles. Diastasis is not a true hernia and not considered to be necessary medical treatment.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 39 reviews

Tummy Tuck - Am I A Candidate?

Thank you for your question.  While most insurance companies will cover an umbilical hernia repair, very few will pay for repair of rectus diastasis.  Please see a board certified plastic surgeon for an in-person examination to discuss the specific details of the procedures. Hope this helps!

I have an umbilical hernia and diastasis recti. Will insurance cover the repair of both?

Thank you for sharing your question and I am sorry to hear of your symptoms.  Most insurance companies will deem an umbilical hernia, especially one that is symptomatic, to be medically necessary and will cover the cost of repair.  A diastasis of the rectus muscle, however, is not considered medically necessary and insurance will not cover these associated costs.  If you would like both repaired, the hernia will help defray the costs of the diastasis repair, but be sure to see a board certified plastic surgeon in consultation.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 35 reviews

Hernia and diastasis recti

Most likely your insurance will cover the hernia repair. The diastasis repair is another story. Your plastic surgeon will need to submit your medical documentation to your insurance company prior to your surgery to get approval. It is sometimes approved in very limited circumstances and each insurance company has their own criteria for approval.
Good luck!

Brian Widenhouse, MD
Charleston Plastic Surgeon
4.1 out of 5 stars 36 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.