When is a Tummy Tuck considered a Non-Elective procedure by medical definition/ health insurance definition?

A Tummy Tuck is not considered medically necessary. It is considered cosmetic. A panniculectomy  could be covered by insurance but it is a limited procedure. It only involves removing excess skin of the lower portion of the abdomen. It does not sculpt your abdomen or tighten your muscles. 

Hello, you would need to check with your local insurer or plastic surgeon but in my region (Ontario) a tummy tuck is never an insured procedure.  Occasionally a related procedure, called a panniculectomy, is covered.  This operation only involves removing a strip of overhanging skin from the lower abdomen.  However it is even difficult to get this covered and it is usually considered an elective operation.

Hi,Tummy tucks are an very extensive cosmetic procedure that elevates the skin, removes extra tissue, recreates the belly button and gives a pleasing cosmetic shape.  OHIP (Ontario) does not cover this. But....what they may cover is a panniculectomy.  This procedure removes the lower abdominal tissue that overhangs. It is NOT a tummy tuck but rather a procedure that takes all skin/ fat that overlaps and removes it.  It is often covered for medical reasons such as infection.  Your surgeon would have to write a letter on your behalf to OHIP. If done together with a cosmetic procedure it can result is substantial savings to the patient.  Not all surgeons will advocate to OHIP for this, so be sure to ask.Dr Rodger ShorttOakville Plastic SurgeonAss't Clin Professor &Director of Cosmetic Surgery Training,McMaster University

Hello. Insurance questions about abdomens are vey common and there is some misunderstanding about it. When you have lost over 100# and have medical problems like rashes, and skin breakdown under the large flap of skin called the panniculus, then sometimes the insurance will cover this. For smaller problems, they usually will not cover it, since the patient can manage this with powders and the flap is not really very large. Good Luck.

A tummy tuck is an elective procedure that insurance will not cover.  However, a panniculectomy may be covered by some health care plans.   To have insurance consider coverage, only the skin below the umbilicus (belly button) would be removed.  Additionally, approximately one year of documentation by a primary care physician is necessary to prove that other strategies haven't worked (for instance weigh loss).Best of luck. 

We have never had an insurance approval for tummy tuck despite many efforts for individuals such as yourself. Some plans will cover removal of the lower skin fold if there have been infections like you describe, not a tummy tuck, but might be helpful to you.

When there are areas severe of skin irritation or chronic wounds resulting from an overhang of skin certain insurance companies may regard a tummy tuck as being medically necessary. Normally you will need to demonstrate that other nonsurgical treatments have proven unsuccessful. It would be best for you to consult with a board certified plastic surgeon trained and experienced in all forms of abdominal recontouring. Your doctor can formulate a preauthorization letter to determine whether or not a tummy tuck would be covered under insurance. Good luck!For a simple and illustrated explanation of tummy tuck and body contouring
procedures, watch my video.

Sorry to hear that you are having problems with your abdomen.  Tummy tuck is usually considered to be an elective surgery where excess skin and fat is removed and muscle is repaired to give a good abdominal contour.   If you do have documented medical problems (infection, maceration) arising from pannus (hanging lower abdominal skin/fat), talk to your primary care physician and a plastic surgeon.  Depending on your insurance policy, panniculectomy may be covered..  Please know that panniculectomy does not include muscle repair and belly button translocation.  Best regards.

I am sorry to hear about the problems you are experiencing. I have never had an "insurance" entity authorize tummy tuck surgery. In other words, insurance companies do not consider this operation medically necessary. Sometimes, however insurance companies will cover excision of lower abdominal wall skin/apron; this operation is called a panniculectomy. Best wishes.