My Moms Insurance Paid for Her Tummy Tuck After a Lot of Weight Loss. I Am 350lbs, Will OHP Cover Me?

Question

My mother was about 250lbs before she dropped to around 170. After 5 kids this had left her with sagging skin. Her insurence paid for the tummy tuck because it was giving her painful and sometimes bleeding rashes. I am 27 and I am 350lbs. I do have one child. If I were to lose a lot of weight I know I will have the same saggy skin. I do have OHP and was wondering if it has been covered in my mothers type of case with insurences like OHP or OHP itself.

Larry S. Nichter, MD, MS, FACS · Answer

Unfortunately, insurance does not cover a tummy tuck. Occasionally with documentation of recurrent infection they will pay for a panniculectomy (simply removing loose skin).#tt#tummytuck

Jonathan Saunders, MD · Answer

it is possible, but some states are more difficult than others. the insurance company does not care that the skin is there. they only care if it causes functional prolems. start complaining and documenting rashes and infections to all doctors. good luck

Michael Kreidstein, MD, FRCS(C) · Answer

People often use terms like tummy tuck/abdominoplasty/panniculectomy interchangeably, but OHIP (Ontario Health Insurance Plan) will cover only panniculectomy, and only if the excess skin extends over the pubic area and causes skin breakdown or other bad problems.  It sound like you may be a candidate for panniculectomy if you are successful with weight loss.

	Good luck!

Lawrence Iteld, MD · Answer

Most insurance policies view abdominoplasty as a cosmetic procedure and do not cover the surgery. They may cover a panniculectomy- this is similar to an abdominoplasty but does not involve tightening the muscle layer or liposuction. I suggest that you inquire with your insurance carrier regarding coverage and with your plastic surgeon about which procedure would be most appropriate for you.

Mark A. Schusterman, MD, FACS · Answer

Post weight loss tummy tucks (panniculectomy) were routinely paid for by insurance but it is getting harder and harder to get them to cover it. You would have to show extreme problems due to the pannus such as chronic infection or skin irritation, and have a requesting letter from your PCP.

My Moms Insurance Paid for Her Tummy Tuck After a Lot of Weight Loss. I Am 350lbs, Will OHP Cover Me?

Answers (5)