Will Medicaid cover a mommy makeover for medical reasons?

Insurance will pay for a hernia repair almost always. They will not pay for diastasis recti repair. They will pay for a breast reduction if you meet the criteria. They will not pay for an augmentation or lift. They may pay for a panniculectomy if you skin hanging over 2 inches. This is not a tummy tuck. They will not pay for a tummy tuck or mommy makeover.

Thank you for your question, unfortunately I do not believe I have ever heard of Medicaid covering any procedure that may be a part of a mommy makeover because these procedures are purely cosmetic. Occasionally a breast reduction may be covered by insurance, but getting approval may be difficult. Insurance companies want to see that a patient has first tried nonsurgical means, such as physical therapy and/or chiropractic treatments, to resolve issues such as neck, back, and/or shoulder pain. If problems still persist, it helps for a patient to have several doctor recommendations, such as from a primary-care doctor, gynecologist, plastic surgeon, and chiropractor to have breast reduction surgery. A substantial amount of tissue, about a pound in weight or 400-500cc, needs to be taken from each breast in order for health insurance carriers to deem the surgery necessary.

No. They can't think of any reason why Medicaid would cover a mommy makeover procedure. Typically insurance does not cover cosmetic procedures.

Mommy makeovers procedures are adjusted to the patient's goals but typically include body contouring with liposuction of the abdomen, sides, back, and bra rolls, a TT, and a breast augmentation/breast lift.Mommy makeovers are considered cosmetic procedures, not medical necessities; and are, therefore, not covered by health insurance such as Medicaid. 
Kenneth Hughes, MD, Board Certified Plastic Surgeon
Los Angeles, CA 

Thank you for sharing your question.  Medicaid will consider all mommy makeover procedures to be aesthetic and "not medically necessary."  Hope this helps.

Insurance does not cover elective cosmetic surgery. Two circumstances that may be covered are breast reduction and panniculectomy. Please do not confuse this with a tummy tuck- they are very different procedures. A panniculectomy is indicated for severe hanging lower abdominal skin that interferes with hygiene, causes documented infections, or problems with daily activity. Additionally, unlike a tummy tuck, a panniculectomy does not allow liposuction or diastasis repair. Breast reductions may be covered by insurance provided that certain criteria are met including amount of tissue removed, documented neck or back pain, and attempts at conservative management. Breast lift and breast augmentation are not covered.Please discuss your concerns and goals with your surgeon who can best assess if it is reasonable and appropriate to submit for insurance review.

A mommy makeover is a marketing term that usually refers to a procedure, or combination of procedures, performed to change a woman's aesthetic appearance after she's done having children.  A mommy makeover often involves a breast augmentation and/or lift as well as a tummy tuck and/or liposuction.  All of these procedures are cosmetic, and there is no medical necessity to have them done.  Therefore, neither Medicaid nor any other insurance carrier will cover their cost.  There are certain situations where patients have medical necessary procedures, such as a hernia repair, performed at the same time as a mommy makeover.  In these situations, insurance may cover the cost of the medical necessary portion of the operation, but anything cosmetic will need to be paid separately by the patient directly.A visit to a plastic surgeon's office will help you to understand if you're a candidate for the procedure, and what aesthetic outcomes are realistic in your particular case.  In order to get a qualified, ethical, and expert opinion on your surgical options and expectations, always schedule an in-person office consultation with a plastic surgeon certified by the American Board of Plastic Surgery.
I'm happy to see you for a free consultation in my New York office.
Best of luck,
Keith M. Blechman, MD
New York, NY

A mommy makeover can refer to various combinations of procedures, but the majority are cosmetic procedures that are not covered by Medicaid, or any other insurance for that matter.  Usually a mommy makeover refers to breast augmentation and/or breast lift, tummy tuck, +/- liposuction, +/- labiaplasty. None are considered medically necessary, though if you have a long-standing history of rashes below the breasts, some insurance plans may cover a breast lift (very unlikely with Medicaid). Regarding the abdomen, a panniculectomy is sometimes covered by insurance if there is an apron of skin hanging down and causing rashes that do not respond to conservative measures. However, insurance will not cover a tummy tuck. Basically for any insurance to cover a surgical procedure, it must be considered medically necessary. 

A mommy makeover is considered cosmetic surgery and insurances do not tend to cover them. However, a mommy makeover consists of different procedures combine together and a breast reduction could be part of it. Which in that case, medical insurance could cover the breast reduction portion depending on the medical reasons.

Medicaid does not cover a Mommy Makeover because those procedures are considered cosmetic. Medicaid will sometimes cover a breast reduction, if it is deemed medically necessary.Good Luck!