Will my Medicaid and Medicare pay for this tummy tuck if I stay in South Carolina?

Classified as a cosmetic procedure, a TT will not be covered by Medicaid or Medicare. You might qualify for a panniculectomy, which removes excess skin and fatty tissues in the abdomen, although it doesn’t involve muscle tightening.

Thank you for sharing your question.  Medicare may be able to pay for a panniculectomy (removal of any apron of skin and fat from the abdomen) but neither will pay for an aesthetic operation such as a tummy tuck.  Hope this helps.

Dear leshannon mcbeth,Insurance will cover a panniculectomy, which is a very different procedure than a tummy tuck. It is important to consult with a board-certified plastic surgeon to learn about the differences between the two procedures. Many of my patients come in thinking the two surgeries are the same, and when they learn the difference they almost always choose a tummy tuck.Good luck,Nirmal R. Nathan, M.D.

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgeons
RealSelf Top Doctor

Insurance coverage will hinge on medical necessity.Following massive weight loss, if a case can be made for medical necessity, skin removal may be covered. Excision of an abdominal pannus (hanging skin apron) is commonly covered.It is important for patients to understand the difference between a cosmetic abdominoplasty and a pannus excision. The latter will only address symptomatic hanging skin. Any additional contouring will not be covered.As always, discuss your concerns with a board certified plastic surgeon (ABPS).Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic
Surgery, American Society of Plastic Surgeons
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Thank you for your question. As it turns out, Medicare and Medicaid will not pay for a tummy tuck, even after weight loss surgery. Be sure to see a board certified plastic surgeon if you plan to move forward.

Hello and thank you for your question. Tummy tuck and other body contouring procedures are cosmetic and not covered by insurance. I would seek consultation with a board-certified plastic surgeon for a full evaluation and advice. Best,
Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

I think you will have a hard time getting Medicare to cover it or finding a surgeon willing to perform it under Medicare. The problem is that Medicare does not preauthorize. That means the surgeon doesn’t know ahead of time if Medicare will pay and if it does it will pay poorly. Medicare is hard to predict and it will be difficult to find a surgeon who will take the chance. Most standard insurance companies do not cover tummy tucks.

Dear leshannon mcbeth,
tummy tuck is elective procedure so insurance companies won't cover the costs. The cost of surgery depends on a lot of factors (type of surgery, number of treated areas, anesthesia fee, surgeon, facility fee, city, etc.). It would be the best to visit or call plastic surgery offices and ask for a price.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

A tummy tuck is considered a cosmetic procedure and is not covered by insurance.  Sometimes a procedure called a panniculectomy is covered, which is essentially removing a fatty apron.  This is not the same as a tummy tuck however.  If you are interested in a tummy tuck, be sure to see a board certified plastic surgeon near you.

A tummy tuck is separated into two different procedures when it comes to insurance paying. Insurance when the procedure is covered will only pay for amputating the skin which is a procedure called a panniculectomy. This is part of a tummy tuck. A tummy tech also includes undermining the skin and fat up to the rib cage, muscle tightening and repositioning of the bellybutton. This part of a tummy tuck is not covered by insurance because it doesn’t deal with the one medical condition that covers a panniculectomy.The only medical diagnosis that warrants a panniculectomy is chronic skin infections that can’t be treated with anything other than skin removal.If you don’t have chronic skin infections then no insurance will pay for any part of the procedure.Even those who qualify for getting insurance coverage of a panniculectomy often are denied.Sometimes plastic surgeons will split the procedure excepting medical insurance for part of the tummy tuck and charging the patient cash for the other part. This can lead to great cost savings for facilities and overnight stay.This is something you will need to talk to plastic surgeons about during in person consultations.If you don’t have chronic skin infections then the procedure will not be covered for sure. There is no other diagnoses that warrants  a panniculectomy.Best, Mats Hagstrom MD