How to get a tummy tuck covered by insurance

Insurance will probably cover an umbilical hernia when fixed at the time of a tummy tuck.

I encounter fascial defects (eg. umbilical hernia) with abdominoplasties all the time. Fixing them is part of the operation and I charge no more for doing it. If the patient wants reimbursement from the insurance company, I’m glad to provide the operative report substantiating the claim. (Vincent N. Zubowicz, MD, Atlanta Plastic Surgeon)

Having an Insurance-paid Umblical Hernia Repair at the same time as a Tummy Tuck

A lot of women have umbilical hernias and wish to have them repaired at the same time as a Full Tummy Tuck BUT have their insurer pay for the cost of the umbilical hernia repair. Problems – You are ASSUMING your insurer would gladly pay for your umbilical hernia repair.

A tummy tuck covered by insurance

Your particular plan may not pay for it or require you to have it done by only certain surgeons who may not want to wait and work with your Plastic surgeon. It is unlikely that the insurer would want to pay the Plastic surgeon to fix it OR that your Plastic surgeon works with your insurer. Your Options: – Pay your Plastic surgeon to do your Tummy Tuck – forget the insurance company. The vast majority of us have trained and certified as general surgeons and are very comfortable fixing umbilical and ventral hernias. Moreover, most of us will not charge you extra for fixing an umbilical hernia in the course of a Tummy tuck. – Have your umbilical hernia fixed by an insurance company approved surgeon and have your Tummy Tuck done a few months later when you are ready for it.

See a General Surgeon for your umbilical hernia and ask if he would consider working with your Plastic surgeon. Let them coordinate the surgery. You may run into major reluctance due to their experience with your insurance company’s past behavior (non payment and delay of payments especially if the case is deemed “Cosmetic”). (Peter A. Aldea, MD, Memphis Plastic Surgeon)

Insurance coverage for a tummy tuck and hernia repair

How to get a tummy tuck covered by insurance photo

Tummy tucks are a very popular and effective way to contour the abdomen. It is possible to perform this surgery in conjunction with other surgeries such as gynecologic procedures or hernia repairs. If you have a small hernia or a separation of your abdominal muscles, your plastic surgeon may feel comfortable in repairing this by himself or herself.

However, it is a significant hernia or one that requires a mesh repair, they may recommend to perform this procedure in conjunction with a general surgeon. In this case, insurance may cover the repair performed by a general surgeon. Coverage for this technique will depend entirely on your policy and your insurance company.

Work with your plastic surgeon to obtain preauthorization for the hernia repair portion before your procedure. (Pat Pazmino, MD, Miami Plastic Surgeon)

Medical costs are covered for medical issues

How to get a tummy tuck covered by insurance question

Although many insurance companies would have you believe that medical problems treated at the same time as a cosmetic procedure, this is more an attempt to not pay for your medical problem.

At the least, they should pay for the medical treatments for the hernias, as well as the hospitalization and anesthesia bills.

The last two bills may be prorated so as the pay only for that part of the procedure that is medical realted. (Robert M. Freund, MD, New York Plastic Surgeon)

Yes, tummy tuck can be covered by insurance

Hernias are frequently discovered either during a consultation or even during the abdominoplasty surgery (asymptomatic). In both cases, repairs can be covered by the health insurance. (Gregory Turowski, MD, PhD, Chicago Plastic Surgeon)

Yes, umbilical hernia repair and abdominoplasty at the same time is possible

Tummy tuck surgery covered by insurance

Yes. It is possible to undergo an umbilical hernia repair and abdominoplasty at the same time. Most insurance plans will cover the umbilical hernia repair; however, they will not cover the abdominoplasty. You should check with your plastic surgeon to see if they accept insurance payments or will assist you in billing your insurance. (Sanjay Grover, MD, Orange County Plastic Surgeon)

Many surgeons, myself included, would be very accommodating to this type of request. Your biggest out of pocket concerns might be anesthesia and hospital fees if your surgery is performed in a hospital operating room. You can save a significant amount of money by having your surgery in an office operating room with a plastic surgeon that can perform both procedures.

Some insurance carriers will cover anesthesia and operating room fees in this setting. (Kenneth R. Francis, MD, Manhattan Plastic Surgeon)