Is Abdominoplasty considered reconstructive surgery? And does Medicaid cover it? (photos)

Unfortunately health insurance, including Medicaid, does not cover cosmetic procedures and abdominoplasty, also called a tummy tuck, is considered a cosmetic procedure. The definition of cosmetic surgery varies, though from an insurance perspective, cosmetic surgery refers to any surgery with the purpose to modify or improve the appearance of a physical feature with no specific medical reason to do so. A medical need could include a condition that causes significant physical dysfunction or psychological distress to a patient, but many health insurance companies have defined criteria to determine if the surgery meets the requirements for coverage.

Thank you for your question. An abdominoplasty is a cosmetic procedure and would not be covered by health insurance. The umbilical hernia repair would be covered by insurance, and that procedure would be performed by a general surgeon.

An abdominoplasty is not covered under insurance. It is considered a cosmetic procedure. The hernia would be covered if you went to get that repaied.

No and no. Insurance companies cover medically necessary procedures. They do not cover procedures designed to improve appearance. If you can prove that the excess skin (pannus) that hangs over your private area is the source of rashes that are non responsive to powders and other non surgical approaches they may cover a panniculectomy. A panniculectomy is a medically necessary procedure designed to remove only the hanging skin to treat and recent those rashes and infections. Hope this helped!

Thank you for sharing your question and photographs.  Thought an umbilical hernia repair can be covered by insurance the other aspects of an abdominoplasty - muscle tightening and skin excess removal - would not be.  Best to consult with a local ASPS board certified plastic surgeon so that you can be evaluated and options discussed. 

Correction of the umbilical hernia may be covered as that is a medical issue, but abdominoplasty is a purely aesthetic surgery that insurance/medicaid won't cover. The only way to know for sure is to book a consultation with a board certified plastic surgeon near you to see what your options are. Best of luck!

Unfortunately abdominoplasty is not covered by Medicaid.  Your umbilical hernia repair is covered.  Thank you and best wishes