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

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

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.

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

Answers (9)

Answer: Does Medicaid pay for a tummy tuck?

Answer: Does Medicaid pay for a tummy tuck?

Answer: If you can prove your back issues

Answer: If you can prove your back issues

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Everything you need to know about Tummy Tuck

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

Answers (9)

Answer: Does Medicaid pay for a tummy tuck?

Answer: Does Medicaid pay for a tummy tuck?

Answer: If you can prove your back issues

Answer: If you can prove your back issues

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Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.