Severe Diastasis Recti - Tummy Tucks Not Covered by HMO's, What Are My Options? (photo)

Baffled!!! As u can see, I have a severe case of it! 7 yrs now, was told by 2 surgeons that I need it but I have 2 pay for it myself,divorced mom of 2 n can't afford it, had 2 hernia surgeries within 5mos in 2006, was not informed I had it til 2008. did it all, PT, exercise, chiro, etc...nothing has helped. I suffer chronic back pain, very limited 2 what I can do, but still workout @ the gym...not a fat person, I look like I'm ready to giv birth...I don't know what 2

Doctor Answers 5

Insurance coverage for TT

Insurance will not cover tummy tuck or diastasis repair. The hernia should be addressed by a general surgeon. Best results for any surgery are if you are close to your ideal weight.

Tampa Plastic Surgeon
4.3 out of 5 stars 34 reviews

Tummy tuck

Most insurance companies do not pay for an abdominoplasty or repair of rectus diastasis.  They should pay if you have a true hernia, but most insurance companies consider your procedure to be a cosmetic operation.  the insurance companies have a lot of experience with people who want them to cover the cost of a tummy tuck, so even with your physical symptoms, they will consider it to be cosmetic.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews


From your picture as best as I can tell you appear to have 4 problems.

1. Excess skin

2. Excess fat under the skin

3. Stretched out muscle layer

4. Excess fat in the belly(visceral fat).

Your breast course of treatment would be to diet and exercise down to a reasonable weight. It is the ONLY way to reduce the visceral fat. Once you have reached that point you can proceed with a full tummy tuck. If insurance does not cover you will have to pay yourself, but by losing the weight and getting into better shape you will feel and look much better even without the surgery.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 34 reviews

Options for protruding abdomen.

For your best result and safest surgery you should lose weight prior to considering any surgery.  From your photo you have intraabdominal fat which is pushing your upper abdomen out.  Trying to do a repair of your diastasis at present would be difficult and likely to fail.  The standard, safe way to decrease your weight is through diet and exercise, with determination and patience.  Once your weight is closer to normal you could proceed.  Insurance never covers  repair of diastasis, so begin saving your money now for this cost.  Plastic surgery teaching programs may have reduced rates for surgery, if this is available in your area.  Good Luck.

Jeffrey M. Darrow, MD
Boston Plastic Surgeon
5.0 out of 5 stars 98 reviews

Repairing the abdomen

First of all, no insurance will cover rectus diastasis.  Also, you do look quite overweight and at present that makes you not a good candidate for surgery.  You first need to lose weight to decrease the pressure inside the abdomen pushing out against a future repair.  Meantime, you can save for surgery and possibly consider having it done at a University teaching program where the costs might be more approachable.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.