Common for Insurance to Cover Tummy Tuck?

Question

After having had three c-sections, my lower belly has loose skin and a huge smiley face. I would like to know, is it common for insurance to cover tummy tuck to remove the excess skin?

Farbod Esmailian, MD · Answer

A tummy tuck or abdominoplasty procedure is a cosmetic procedure and not covered by insurance. A panniculectomy is removal of the fat and skin in the lower abdomen without the tightening of the muscles. This may be covered by insurance but it is usually approved for patients with large lower abdominal pannus with skin issues such as rashed and infections.

Larry S. Nichter, MD, MS, FACS · Answer

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

Francis X. Fleming, MD · Answer

It is unusual for insurance companies to cover a tummy tuck, because it is considered cosmetic. However some insurance companies will cover a panniculectomy, to address very large amounts of loose abdominal skin. You might check to see if any of your local plastic surgeons offer a financing plan. Good luck!

Alfred Sofer, MD, FACS · Answer

Tummy Tuck is a cosmetic surgery and is not covered by insurance.There are 3 types of tummy tuck's. Mini-tummy tuck, Regular and Extended. The cost of a tummy tuck depending on which type of tummy tuck you will need.  Duration of surgery:  2-4 hours depending on the amount of liposuction. In my technique the scar is placed extremely low, approximately 7 cm from the vaginal crease within the bikini line. The belly botton scar is "inny". Muscles are tightened in midline, liposuction of the lower lateral aspect of the abdomen, along with the upper abdomen and flanks to improve the contour. A pain pump in inserted to control the pain for the first 48 hours and reduce the amount of narcotics taken. Anesthesia: General by a board certified anesthesiologist in an accredited surgical facility or hospital settingRecovery after Tummy Tuck:about 3 hours in the recovery room2-3 days in hunched over position. Surgical discomfort is controlled with pain pump and pain meds.10-14 days back to the activities of daily living4-6 weeks normal exerciseFinancing available through CareCredit

Jerome Edelstein, MD · Answer

You will have to consult your insurance provider to find out if your tummy tuck is covered. However, in general, the answer would be no unless it would resolve a physical impairment directly caused by excess skin in the area you want to target, and a tummy tuck is proven to be the most suitable treatment for you.However, you may be able to still cover your surgery with financing. Payments can be as little as a couple hundred dollars a month.

Lewis Albert Andres, MD · Answer

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.   Typically this is a cosmetic procedure and should not be covered.  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. 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!

George Marosan, MD · Answer

Insurance does not cover a tummy tuck. Loose skin and stretched out abdominal muscles are not considered a "functional" medical problem, but are cosmetic. The only procedure an insurance co. might cover is a panniculectomy. This is a condition mainly seen in patients who underwent massive weight loss and now have an abdominl fat apron that covers the pubic area or even can reach down to the mid thighs. Often these patients have infections and skin breakdown in the folds. Removing this excess skin only is a panniculectomy. It is performed mainly by general surgeons ( oddly, they like to call this a tummy tuck). It is not a tummy tuck, it is part of a tummy tuck.

Sam Jejurikar, MD · Answer

In general, insurance companies almost never cover the cost of tummy tuck.  Tummy tuck is a contouring operation, in which loose abdominal wall muscles are tightened, extra skin and fat are removed and reshaped, and the belly button is relocated and reshaped to give it a more youthful appearance.
In some cases, when a patient has a large amount of overhanging skin causing superficial wounds, hygiene problems, or difficulty with ambulation, insurance companies will cover a procedure called a panniculectomy.  Usually a significant amount of preoperative documentation is required to get approval for this procedure, including letters from your primary care physician documenting failure to improve with conservative measures and photographs.  
Panniculectomy is a functional procedure - not a cosmetic one.  The extra skin is removed and the incision is closed - that's it.  There's no tightening of the abdominal wall, there's no sculpting of the remaining skin and fat, and the belly button retains its appearance.  The results are not comparable to a tummy tuck.

Mokhtar Asaadi, MD, FACS · Answer

Thank you for your question. My recommendation would be to call them and ask them before your procedure. Explain your situation and they should be able to direct your answer since it varies from time to time.

Tom J. Pousti, MD · Answer

Unless there is some unusual circumstance, insurance companies generally do not cover tummy tuck surgery. In other words, insurance companies do not consider this operation medically necessary. Sometimes, however insurance companies will cover excision of lower abdominal wall skin/apron;  this operation is called a panniculectomy. Best wishes.

Common for Insurance to Cover Tummy Tuck?

Answers (18)

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