Abdominoplasty - Is it covered by insurance?
An abdominoplasty or tummy tuck is usually not covered by insurance as medically necessary. Many women after pregnancy, who have excessive skin and fat in the lower tummy, also have spreading of the muscles. In the tummy tuck operation, the skin and fat are removed and the muscles are tightened to give a flatter abdomen. When the muscles are spread apart so that there is a hernia (bulging of fat or intestine through the abdominal wall) then insurance may cover the repair which could include a tummy tuck at the same time. If there is an indication for a hysterectomy or other abdominal surgery, a tummy tuck could be coordinated at the same time but it may or may not be covered. Bariatric surgery or surgery to treat obesity will sometimes cause extra hanging skin after the patient has significant weight loss. Insurance may cover the weight reduction surgery but usually does not cover the contouring surgery to remove the skin, which in most cases requires an abdominoplasty. The best solution to the question is to have a consultation and have the surgeon’s office perform a predetermination to see if it is covered under the patient’s policy.
Randolph C. Robinson, M.D., D.D.S., F.A.A.C.S.
