Posted on July 21, 2020 Show
My short answer, after having done tummy tucks for 20 years, is almost no abdominoplasties get covered. So if you are a mommy who has had 3 kids and has some stretched out skin and diastasis (the muscle separation), unless you are truly blown out and look six months pregnant all the time, your abdominoplasty will be considered cosmetic. If you are a major weight loss patient who has lost 50 pounds, unless your skin is hanging low and you have chronic issues with skin breakdown, you are likely not getting your tummy tuck covered as well. This is not to say I don’t think there are real medical benefits from doing a tummy tuck. I think it is a true reconstructive procedure. But insurance does not always agree. But what about those who are truly blown out? Or those who have lost over 100 pounds? The criteria they listed as indicating your surgery is medically necessary by Medicare guidelines:
What wasn’t covered?
My thoughts? Urg. I love tummy tucks for what they do. There are studies which show statistical improvement in back pain and urinary incontinence (BLOG). My patients anecdotally state their bowel habits are better, their core is stronger, they can exercise better (one patient’s golf game improved by 100 yards per hit), some even report better sex. It is a big operation, with a big scar and a real recovery. It is not to be done lightly. But do not use insurance coverage parameters as an evaluation of worth. Those who do abdominoplasties tend to be happy they did. It is frustrating to me and my patients that insurance companies do not include all the symptoms listed above as reasons to cover the surgery. My other caveat with insurance coverage is for those with a large overhanging pannus, sometimes the insurance company will cover a “panniculectomy,” not a tummy tuck. What this covers is technically a wedge of the overhanging skin, not a full tummy tuck where you undermine the skin up to the rib cage and corset the muscles back together. The muscle tightening and mobilizing more skin is part of what elevates the procedure. I've always been told that insurance won't cover any skin removal surgeries because they are considered cosmetic. i have also been told they might cover certain surgeries. I am at a 160 pound weight loss and I have excess skin on my abdomen, inner thighs, arms, back, my breasts are sagging, etc. Basically, I have excess skin almost everywhere and it makes me uncomfortable. I have united healthcare. Does insurance usually help with skin removal surgeries after weight loss? Answer: Insurance help with excess skin2 people found this helpful Answer: Insurance help with excess skin2 people found this helpful Answer: Insurance coverageBook a virtual consultation Answer: Insurance coverageBook a virtual consultation September 28, 2018 Answer: Body lift 360 circumferential lower body lift belt lipectomy belt abdominoplasty lower body expert Los Angeles insurance coveragBook a virtual consultation September 28, 2018 Answer: Body lift 360 circumferential lower body lift belt lipectomy belt abdominoplasty lower body expert Los Angeles insurance coveragBook a virtual consultation June 27, 2015 Answer: Insurance CoverageJune 27, 2015 Answer: Insurance CoverageHow much weight should be lost before having a tummy tuck?It is important that you be close to your desired weight for six to twelve months before undergoing a tummy tuck. Most surgeons will recommend patients be between 10-15 pounds from their goal weight. This is important as gaining or losing additional weight can undo the contoured shape achieved through your surgery.
What is the average weight loss after a tummy tuck?The amount of weight a patient loses after a tummy tuck will vary, depending on the extent of the procedure. In most cases, patients lose a minimal amount, typically under five pounds. Other patients with more extensive loose skin may lose between 5 – 10 pounds, and, sometimes, even more.
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