Question:
When you have hernia repair does insurance automatically pay for a panni. (tummy tuck
I have Cigna PPO. Does anyone know if I have to have hernia repair(s)-yes I have two-if my insurance company would cover abdominoplasty or a panni. (tummy tuck)? — Cinna G. (posted on May 15, 2002)
May 15, 2002
I don't think that they will pay for it automatically. In most instances
it has to be medically necessary. Do you get rases or does the pulling of
extra tissue make your back hurt? These are medical reasons to have the
TT. Everytime you get a rash or your back hurts, have it documented by
your doctor. I had no problem getting approved because I had this done.
— livnliter
May 16, 2002
No, hernia repair does not automatically bring a TT along with it. I just
got my predetermination from my ins. co. (UHC) and thought I was covered
for both... wrong! I plan on appealing (sp?) this decision. Good Luck!
— DonnaCarol
May 18, 2002
I don't have Cigna, I have Unicare, and my surgeon told me that he already
knew that my ins would pay for a TT when I get my hernia fixed...now if I
can figure out the right "window" to do the surgery, maybe this
summer before the kids go back to school..i don't know.
— Jeannie B.
January 9, 2004
I'm 3 years post-op and last Sept. 02, I had a hernia repair and a
Abdominoplasy. My ps told me my insurance would proabably pay for the panni
but he recommended the abdominoplasty. They submitted it, they denied it
saying it was deemed cosmetic surgery, then I appealed and they approved it
because they considered it reconstructive surgery. It's all in the wording
of how your ps writes the notes on your chart. I ended up paying $2000 but
I've heard of others who didn't pay anything. My plastic Surg. ended up
repairing my hernia because my General surg. didn't want to do a
co-surgery. Fine with me, I'm sure my ps did a better job. On a personal
note, I was 338 when I had my gastric bypass Aug.2000. I lost 150. Then 15
mos. ago I had my t. tuck. and lost another 20 lbs. I would totally do the
t.tuck over again in a minute, it was so worth it. I no longer have that
apron and rashes. My tummy is really flat. I can't believe it. The
recovery time was fine. I slept in a recliner in my bedroom for 3 weeks
and had three drains to deal with, but other than that, it was a piece of
cake. My only side effect is numbness. Sometimes the doc's don't tell you,
mine didn't, but I have a lot of numbness. Mine goes all along the incision
lines, both up and down and across from hip to hip. Also my right front and
side of my thigh are completely numb. The doc said is should go away
within a year but it hasn't.
— Melinda C.
October 2, 2005
Finally...I got my "Tips for Getting Your Plastic Surgery
Approved" worksheet on my website. It will help individuals who have
medically necessary issues get their plastic surgery covered, at least in
part, by insurance. Check www.drlomonaco.com under "Patient
Resources" Also there are info and links for patient financing ! ANd
yes, the hernia repair can help coverage for a TT.
— DrL
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