tummy tuck

Hope4life13
on 1/15/15 6:53 am
DS on 10/23/13

Does anyone know  a for sure  way for insurance to approve  a tummy tuck / reconstructive surgery? 

kathkeb
on 1/15/15 7:25 am

It depends on YOUR insurance --- some people have severe infections, open sores caused by friction from the excess skin.

Some insurance companies require documentation of these events for many months (you MUST see your doctor every occurrance and get it documented).

Some insurance policies are easier to work with than others -----

You should check your individual policy and see what their guidelines are -- sometimes the amount of hanging skin needs to be documented -- and counts towards approval.

It is very RARE for insurance to pay for a 'tummy tuck' --- they will usually pay for a panniculectomy, which is simply the removal of the apron of hanging skin ---- no muscle repair, no belly button repositioning or rebuilding.

Some surgeons will allow you to pay the difference between the insurance-paid panni and a full tummy tuck/abdominoplasty.

You need to make sure you understand WHAT is being paid for, WHAT you are getting so you are not disappointed.

I know that I would NOT have been satisfied with a panniculectomy only --- I wanted the full tummy tuck, mons lift, new belly button, muscle tightening.  Worth every penny!

Kath

  
Cicerogirl, The PhD
Version

on 1/15/15 11:37 am - OH

Ditto what Kath said.  

A panniculectomy is often paid for by insurance if you have rash issues (and, for some insurance policies, if it hangs down far enough), but some policies don't even cover that except in extreme cir****tances, so there isn't any "sure" way to even get that covered by insurance.

A tummy tuck with muscle tightening of the upper abdomen is usually considered cosmetic (unless you have a hernia that needs repaired), but there are a few policies that do cover it under certain cir****tances.

Lora

10 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Judy700
on 1/16/15 12:31 pm
VSG on 03/11/14

I'm still losing so I'm not ready to have plastics done yet, but a very well-respected bariatric plastic surgeon in our community came to speak to our support group and he said the same.  It is quite hard to get insurance to pay for much of anything.  You need to have tried everything medically first and documented the failure of all the medication to improve your rash.  This can take over a year.  Only then might insurance help, but they pay for very little.  He said it was literally a drop in the bucket of what he does for a complete tummy tuck.  He said he would apply the insurance payment towards the total cost but it would still cost a good bit more for the typical patient to feel satisfied with the finished product.  He said they work with all their patients to help finance whatever it is that needs doing. I know I will need at the very minimum a good tummy tuck done, so I'm not even going to try to fight with my insurance for this.  I'm not ready yet at all, because I'm only 10 months out and still losing, albeit slowly.  The surgeon who spoke with the group said he wants his patients to be weight stable for at least 3 months before going forward with any plastic surgery.

VSG on March 11, 2014. 60 yo female from Washington, DC area. 

HW: 235  SW: 230  CW: 134.5 (3/23)    M1:-19    M2: -13   M3: -10.4    M4: - 8.2   M5: -6.4    M6: -5    M7: -7.4    M8: -4    M9: -8.6    M10: -5    M11: -3.6    M12:  -1.5 Goal reached 3/23/15 in 1 year + 12 days following surgery.  BMI from 42.1 to 23.9 

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

hollykim
on 1/18/15 5:49 am - Nashville, TN
Revision on 03/18/15 with
On January 15, 2015 at 2:53 PM Pacific Time, Hope4life13 wrote:

Does anyone know  a for sure  way for insurance to approve  a tummy tuck / reconstructive surgery? 

there is no "for sure way". Every insurance company,surgeon and patient present different requirements. 

 


          

 

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