Tummy Tuck with Muscle and Hernia Repair Covered by Insurance?

Good question.  Both of these procedures can be done at the same time.  Tummy tucks and liposuction are cosmetic so they are not covered through insurance and is always the patients responsibility.  The hernia portion of the surgery is something your insurance might cover.Best of luck to you

Thank you for your question regarding combining an umbilical hernia and muscle repair with a tummy tuck. It’s great that your health insurance is likely to cover the hernia repair, as this is considered a medically necessary procedure. Combining this with a tummy tuck, however, is primarily cosmetic, and it’s common for patients to pay out-of-pocket for the cosmetic portion.

Many surgeons are open to combining these procedures because it can be more efficient for the patient, requiring only one surgery and recovery period. In these cases, your surgeon would likely bill your insurance for the hernia and muscle repair, while you would pay for the tummy tuck portion directly. This can make the process more feasible and cost-effective for you.

I recommend discussing this option with your plastic surgeon and insurance company to clarify what will be covered and how the combined billing would work. Surgeons who regularly perform tummy tucks with hernia repair are usually familiar with this arrangement, and it’s a practical option for many patients.

Sincerely,
Dr. Katzen

This is a frequent question, thanks for asking. You are correct in your assumption that your insurance company will likely pay for your hernia repair but not your tummy tuck. It is not uncommon to perform these two procedures at the same time. You would be responsible to pay the out of pocket costs for the tummy tuck (including the facility fee and anesthesia time for the tummy tuck portion of the procedure). By combining the two procedures you will only have to go through one recovery period. Good luck!

Unfortunately, insurance does not cover a tummy tuck. Occasionally with documentation of recurrent infection they will pay for a panniculectomy (simply removing loose skin).#tt#tummytuck

Thank you for your question.  Repair of a small, uncomplicated umbilical hernia is very commonly performed by the plastic surgeon as a part of the tummy tuck operation.  Insurance will usually cover the hernia repair; the tummy tuck (with associated OR and anesthesia time) is paid for out of pocket.  In the event that insurance approval for the hernia cannot be obtained, many plastic surgeons will perform this either free of charge or at a small additional fee.

This is possible but you will have to talk to your insurance provider and surgeon to find out the details of payment. 

Hello! Thank you for your question! Surgical procedures for aesthetic
purposes, to improve appearance, are not covered by insurance.
Typically, these as well as complications resulting from such procedures
are the responsibility of the patient. Procedures that are meant to
correct functional issues and those which cause health-related issues
should be covered by your insurance as a medical necessity, with proper
examination and documentation. Some insurance plans have exclusion
criteria for certain procedures. Also, it is an obligation of the
surgeon not to attempt to authorize purely cosmetic procedures through
insurance.  This is an excellent time to combine these procedures.  The facility and anesthesia time should begin upon completion of your hernia repair.Discuss your issues and
complaints with a board-certified plastic surgeon to discuss these as
well as to examine and assist you in deciding which procedure(s) will be
the best for you. A discussion of the advantages and disadvantages will
take place along with the risks and benefits. Insurance companies will
vary on coverage and is always reasonable to discuss your issues with
your surgeon and primary care. It would behoove you to get as much
information as possible and even call your insurance yourself.
Certainly, pay in advance prior to your surgical procedure and options
such as financing are available if you qualify. Hope that this helps!
Best wishes!

Yes, typically most insurance plans will cover the umbilical hernia repair while you will pay out of pocket for the cosmetic tummy tuck portion of the procedure. This is very common and you should consult with a board certified plastic surgeon for more detailed information depending on your specific health care coverage.Best wishes,Dr.Bruno

Thanks for the question - it is definitely possible for your plastic surgeon to do both procedures at the same time.  You would simply pay for the extra anesthesia time, the extra OR time, and the surgeon's time while performing the tummy tuck as opposed to fixing the hernia.  Best of luck.

Insurance does not cover a tummy tuck but it does cover repair of umbilical or incisional hernias. If a tummy tuck is conducted at the time of umbilical hernia repair the cosmetic portion of the procedure is not covered by insurance.