Is a yeast rash a medical reason for insurance to pay for a tummy tuck? (photo)

Question

On my stomache area I get alot of rashes its been happening for a while now. My dr. Says its some type of yeast rash. Is that a medical reason for the insurance to pay for a tummy tuck? Thank You

George Marosan, MD · Answer

Thank you for your question and photos. A yeast infection in an abdominal fold secondary to moisture in the area can be embarrassing and can give a foul odor. This is not a reason for the insurance to cover a tummy tuck. If you have documented multiple infections, inspite of medical treatment, they might authorize a panniculectomy. This is not a tummy tuck! This procedure can be done by plastic or general surgeons and it only involves removing the excess overlapping skin. See a surgeon for an in person consultation. Good luck.

Darryl J. Blinski, MD · Answer

20 years ago - YES!. Today not a shot in h__l... But you can try by writing a letter of predetermination...

Elliot W. Jacobs, MD · Answer

I
 agree with the other surgeons: it's very unlikely your insurance 
company will cover the cost of abdominal plastic surgery.  That doesn't 
mean you can't find a way to move forward, however, even if you don't 
have lots of extra money to spend.
Start with a consultation or two with a board certified plastic surgeon who performs abdominal procedures often.  He or she can determine exactly 
what procedure would be best for you.  It could be a tummy tuck, a 
modified tummy tuck or "skin only" surgery called a panniculectomy--with
 or without liposuction.  
You can get a quote for all the fees involved and decide what you 
want to do.  Many of our patients save money, pay for part of their 
surgery in cash and finance the rest.Elliot Jacobs, M.D.New York Plastic Surgeon

William McClure, MD · Answer

Thank you for your question and for sending photos. Your question is reasonable but I'm afraid I don't have a positive answer for you. Though you could expect a very nice change with an abdominoplasty, it is very unlikely that insurance would cover the operation despite the yeast infection. As Dr. Kraft noted below, the only patients that could get coverage would be ones with debilitating skin problems that have prompted multiple hospital admissions and treatment with IV antibiotics. If the yeast infections make you very uncomfortable and you don't have the financial means to pay for an operation you might be able to find a qualified surgeon in your area willing to do your surgery at a reduced cost.

George C. Peck, Jr, MD · Answer

Based on your pictures, you are a good candidate for a full abdominoplasty. Insurance companies cover abdominal wall hernias. If you have a weakness in the abdominal musculature, you may receive some compensation for the tummy tuck. Some plans require you to stay in network with referral while others allow you to go to the doctor of your choice. If you don't get insurance coverage, you do not have to spend a fortune. In my practice, the fee for a full abdominoplasty is $6000, which includes the Board Certified Professioanal fee, Board Certified Anesthesia fee, and Medicare Approved Surgicenter fee. Best wishes

Robert L. Kraft, MD, FACS · Answer

The only panniculectomy I have ever gotten covered was on a patient who had been on intravenous antibiotics and had had several hospital admissions over a year for intractable infections. It was an extreme case. If your infections can be medically treated by a dermatologist, panniculectomy or tummy tuck will not be covered.

William B. Rosenblatt, MD · Answer

Although you may want it to be a reason, most insurance companies still deny coverage because the surgery is really cosmetic in nature. If they do cover anything it is for removal of the panus ( which is minimal in you). This reimbursement is very small compared to the total cost of a tummy tuck.

Is a yeast rash a medical reason for insurance to pay for a tummy tuck? (photo)

Answers (7)

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