Do you guys accept the Aetna Medicare advantage insurance? /Medicaid? I'm interested in getting an abdominoplasty done (Photo)

For insurance to cover a tummy tuck, you will have to have lost over 100 pounds and have issues like skin rashes. Also, your primary care physician will have to have treated these rashes for at least 3 months, and then refer you for this. Insurance does not always cover the tucks.

Thank you for reaching out with your inquiry regarding the potential coverage of abdominoplasty by Aetna Medicare. Your shared history and photographs were very helpful, and I commend you on your impressive weight loss journey.

To address your question, it's essential to understand that Medicare, including Aetna Medicare, very rarely covers an abdominoplasty. The procedure they are more likely to cover is called a panniculectomy.

Panniculectomy Explained:
A panniculectomy is a surgical procedure that involves the removal of the pannus (the excess skin and tissue) that hangs down over the genitals and/or thighs. This procedure primarily aims to alleviate the symptoms associated with an overhanging apron of skin, such as skin infections or rashes. It does not involve repositioning the belly button, nor does it address excess skin and fat in the upper abdomen. Additionally, a panniculectomy does not tighten the rectus muscles (commonly known as the "six-pack" muscles). In essence, it is a more functional rather than cosmetic surgery.

Given this, if you're hoping for Medicare coverage, they would most likely only cover the cost of a panniculectomy, given that specific criteria are met. However, if you are seeking a full abdominoplasty, which is more comprehensive and cosmetic, you will likely need to finance the procedure out-of-pocket.

To locate a Medicare-accepting plastic surgeon, I recommend visiting the official Medicare website or dialing the 1-800 number located on the back of your insurance card. Inquire about board-certified plastic surgeons in your area that accept your insurance. Typically, these surgeons can be found at larger hospitals that have plastic surgery residency programs.

I hope this information clarifies the differences between the procedures and the associated coverage nuances. I wish you all the best as you move forward with your decision.

Sincerely,

Dr. Katzen

A tummy tuck is considered a cosmetic procedure and is not covered by insurance. At times insurance will cover what is called a panniculectomy where a hanging apron of abdominal tissue is removed. However this is not the same as a tummy tuck. There are companies that offer financing for tummy tucks and other procedures, as an option to consider.