Insurance pay for tummy tuck?

JJB · May 16, 2006

I was just wanting to see if any one was able to get insurance to pay for there Tummy Tuck. I still have a ways to go but deffinitly am interested in this. A plastic surgeon spoke in our last support group and said that insurance does not cover it. But I have heard different things. What was your experience? I have United Health Care now but I have the option to change to Health First for next year. I am going to try and see if either of them cover it. Any input would be great.

centerfolds · May 16, 2006

Excessive ,flabby,hanging skin is NOT a medicial emergence.You cant get sick from it,it isnt life-threatining & cannot turn into anything risky to myour health.Its COSMETIC SURGURY and insurrances are excempt from that! Thats like asking your insurance to cover porcilian crowns from a Dentist or hair extentions from a beauty saloon! Sorry!

Kryssa · May 16, 2006

<TABLE id=HB_Mail_Container height="100%" cellSpacing=0 cellPadding=0 width="100%" border=0 UNSELECTABLE="on"><TBODY><TR height="100%" width="100%" UNSELECTABLE="on"><TD id=HB_Focus_Element vAlign=top width="100%" background="" height=250 UNSELECTABLE="off">My chiropractor said he was going to write mine up as a medical necessity because I am sway-back from all the extra weight and skin pulling on the front. Same idea as a breast reduction: it's effecting my spine, results in rashes, etc. You will have to see how much skin you have...and then petition your insurance. Good luck.</TD></TR><TR UNSELECTABLE="on" hb_tag="1"><TD style="FONT-SIZE: 1pt" height=1 UNSELECTABLE="on">

</TD></TR></TBODY></TABLE>

JJB · May 16, 2006

A lot of people get yeast infections from it hanhing there. And I know that I have had a problem for about a year with my hip hurting from the weight of it hanging. A friend of mine had one two years ago and her insurnace did pay for it. She had lost 200 pounds and the crease skin opened up so it was considerd a medical problem. You can get an infection bad enough that it affects your blood. So that is why I wanted to see how often it is covered.

roseann · May 16, 2006

I work with a plastic surgeon one day a week and from what I gather from him and the talk in the office, ins. does mostly cover it if you are a bypass or banded patient. It should not be considered cosmetic. It is a medical necessity when it hangs and gives rashes, back problems. You gotta fight it, and if it comes back rejected, you gotta keep fighting. You have to get your dr. to write up a really good letter, and begin now with the documentation of the rashes you get, or yeast infections, and all the treatments you need. Just keep track of all that, and when you go to the plastic surgeons for your consult, have all that ready to give to them to send into the ins. co. The stomach also has to hang down a certain amount for it to be covered. Start documenting any dr. visits now for problems. Good luck.

JJB · May 16, 2006

Thank you for the info. I will start working on this when I get about 30 pounds away from my goal weight since it will probably take a while.

Marimaru · May 16, 2006

I think you need to be able to prove that the skin is a problem. Any time you have even the smallest rash in the area you want taken care of, take pictures, and go to your doctor so that it is documented.

And it's also highly likely that insurance will deny it anyway, but you may be able to get approval on appeal.

cissy · May 17, 2006

I heard the same thing that Sarah said. If you get rashes where the skin hangs over, go to the doctor to have it documented. I got a rash a couple of times right on the edge of my hanging belly near my hip that turned into small ulcers that bled a little. I really wish I would have seen a doctor about it, but now I know. Next time it happens I'm going PDQ!