Is it possible to get Medicaid to pay for a full tummy tuck? I have Molina Healthcare.

Question

In May of 2009 I gave birth to my twin daughters. I have loose skin & I am pretty sure my stomach muscles are severely separated. I have lower back pain & I am pretty sure that because my stomach muscles are separated that they are not holding my internal organs where they are supposed to be.

Anita Patel, MD, FACS · Answer

Medicaid would not be expected to cover a tummy tuck, since it is considered a cosmetic procedure. Sometimes you can get coverage for a panniculectomy, which is different from a tummy tuck, and involves simply excising the "apron" of overhanging skin at the lower abdomen. This would require you have a pannus that is causing medical issues that do not respond to conservative measures. Repair of muscle separation is also not considered a "medical necessity". If you have a hernia, however, this can be covered by insurance, but it is not the same thing as the muscle separation (diastasis recti) that you describe. If you do have a hernia or symptomatic abdominal pannus, then you may qualify for coverage of hernia repair or panniculectomy. You may want to start with finding a surgeon who accepts Medicaid, and scheduling a consult.

Chad K. Wheeler, MD · Answer

tummy tucks are not covered by insurance.  They will sometimes only cover a “paniculectomy” which is only the removal of the overhanging skin and fat to reduce skin on skin contact and therefore reduce or prevent rashes and improve clothe fitting.  The insurance companies are not interested in what it looks like afterwards and therefore most patients are unhappy with a paniculectomy when they are trying to get a tummy tuck result.

Kamran Azad, MD · Answer

Unfortunately cosmetic procedures are not covered by insurance. The definition of cosmetic surgery varies, though from an insurance perspective, cosmetic surgery refers to any surgery with the purpose to modify or improve the appearance of a physical feature with no specific medical reason to do so. A medical need could include a condition that causes significant physical dysfunction or psychological distress to a patient, but many health insurance companies have defined criteria to determine if the surgery meets the requirements for coverage.Kamran Azad MD, Board Certified Plastic Surgeon

Camille Cash, MD · Answer

A tummy tuck is considered a non medically necessary cosmetic procedure and is not covered by insurance.  You can explore a panniculectomy which is sometimes covered by insurance.  This removes a hanging apron of skin.  This is different than a tummy tuck which would address excess fat and skin as well as correct abdominal wall separation. Many surgeons accept financing through companies such as PatientFi and CareCredit who specialize in financing medical procedures.

Curtis Wong, MD · Answer

are directly related to your tummy, coverage may be extended but this is a rarity indeed.  You're better off saving for this and having it done cosmetically where there are standards to meet in terms of aesthetics.  If your insurance did cover this, there is no incentive at all for your surgeon to do the best job possible when it comes to aesthetics as a completely different mindset is involved with cosmetic versus medically necessary procedures.

Nicholas A. Flugstad, MD · Answer

I see many twin moms in my practice, and the abdomen recovery is much different. Severe widening of the abdominal muscles (rectus diastasis) can occur, and this causes many functional issues. I believe this to be a functional problem, but it is not a true hernia. Therefore, insurances have chosen not to cover this. Unfortunately, it requires out of pocket expense for surgery. The results are quite reliable and your tummy can be made much flatter when plicated properly.

Karl William Schwarz, MD · Answer

Does Medicaid pay for a tummy tuck?
No Medicaid will not cover a dummy touch. Hey tell my tongue is a cosmetic operation and is not consider therapy for any medical diagnosis and as a result will not be covered by any insurance company

Tahira Prendergast, MD, FACS · Answer

Unfortunately a tummy tuck is a cosmetic procedure and will not be covered by insurance. They may cover a panniculectomy which is removal of excess skin, but this does not include muscle work.

Ronald V. DeMars, MD (Retired) · Answer

Sorry but tummy tucks are cosmetic surgery and never considered treatment for back pain. Insurance companies of all types do not pay for any cosmetic surgery.

Richard P. Rand, MD, FACS (retired) · Answer

Despite your issues, and these are shared by all tummy tuck patients, the insurance industry has determined that a tummy tuck is not considered "medically necessary" for your health or survival. Consequently, they don't provide coverage. Patients considering this very beneficial surgery pay on their own for it.

Is it possible to get Medicaid to pay for a full tummy tuck? I have Molina Healthcare.

Answers (10)

More Tummy Tuck Questions

WE SEND PRETTY
EMAILS

Answers (10)

More Tummy Tuck Questions

Could bad scar tissue cause issues for a tummy tuck?

Tummy tuck that creates very small waist, is there a name for that?

Do I have enough skin for a full tummy tuck? (Photos)

Tummy Tuck/scar: how long does it take for the stitches to dissolve?

Tummy tuck drain holes, 9 months post op, is it normal to have such deep indentations.

I thalasemia trait and im having a tummy tuck in 02/20/18 my hemoglobin is at 11.3 is this safe?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS