Question:
Does anyone know if United Healthcare Ins. usually covers the tummy tuck operation.

When I had my Open RNY my insurance was BCBS of TN PPO with Medicare as my secondary insurer. BC did not pay any of my surgery. As of March of 2003 we now have United Healthcare as our Primary Insurance, I have Medicare as Secondary because I am disabled due to chronic pain. I am hoping that United pays for the tummy tuck as I have had to have 3-4 more open surgeries since my WLS surgery for hernia removals and for an abdominal abcess so my abdomen is a real mess. May 20th. 2003 will be one year since my surgery and I do want to wait at least 18 -24 months for the tummy tuck. I was just hoping someone might have an answer for me. Thank you and good luck to everyone out there on their journey to the other side. Hugs and Love----Avis    — Avis D. (posted on April 21, 2003)

April 20, 2003
It depends on your particular plan. I'm in the appeal process with them now on this very issue. Get a copy of your policy booklet and look for the Exclusions section. If it's excluded, it may say for cosmetic reasons. There's the trick - most insurers insist abdominoplasty/panniculectomy are cosmetic procedures, which they can be indeed. However for most of us it's way beyond that. Document all medical problems you have as a result of the excess skin. No guarantees with it, but almostly certainly will be denied without it.
   — scottiemaam O.

April 21, 2003
Most insurance will not cover a true "Tummy Tuck" because they consider it cosmetic. Many times insurance will cover a Paniculectomy (skin removal only) and then you can pay the surgeon yourself for the muscle tightening. So the insurance will usually cover the hospitalization but only part of the surgery cost.
   — Charla K.

April 21, 2003
It depends on your policy and their definitions regarding Cosmetic and Reconstructive. I have UHC EPO out of Salt Lake City, UT and I had rashes, infections, back, neck, shoulder pains, go to physical therapy, and chiropractor , dermatologist on a regular basis and fought them through four appeals and an external review and was still denied. I hope you get approved, but I am afrai it all depends on your case and your policy. Good Luck.
   — Teena A.

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