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

Umbilical hernias are quite common and occur in the setting of a previous surgery, pregnancy, or diastasis recti. We treat umbilical hernias with or without correction of diastasis recti using a combination approach that corrects redundant skin in the lower abdomen and around the belly button. If there is a lot of skin, we would use a tummy tuck scar whereas smaller corrections can be performed using just the belly button incision which is well hidden inside your belly button.


Best,
Dr. Karamanoukian
Realself100 Surgeon

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!

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.  

In my opinion, an umbilical hernia is best repaired if a concomitant Diastasis is also closed. Insurance will not cover the Diastasis closure portion, unfortunately. 

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.

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.

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.  

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.

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!