does kaiser pay for a tummy tuck?

[carlacv 27]

not sure where to post this or even if this has been asked before. Wondering if Kaiser would pay for a Tummy Tuck. I had gastric sleeve done by kaiser in 2018 and then a revision due to GERD in 2020. doing good now but need a tummy tuck desperately wondering if anyone has had it paid by Kaiser. Any suggestions are greatly appreciated

[catwoman7 11,212]

I don't know about Kaiser specifically, but most insurance companies generally won't cover this unless you've had medical problems with the excess skin that don't respond to traditional treatments - for example, chronic rashes. If you're experiencing something like that, be sure to see a doctor for it and make sure it's documented, because the insurance company will want to see documentation that it's not responding to more conservative treatments before approving the surgery. None of mine was covered - but for some of us, yes, insurance does cover - but again, it really depends on the situation.

[bluemather 9]

I just met with my surgeon yesterday for my 6 mo post op visit. I brought up this same question as my sagging skin is becoming more apparent as I continue to lose (at 90 lbs lost). He said that most insurance will pay for this procedure as a cause of Bariatric surgery and done by a plastic surgeon. He mentioned that you need to first lose all the weight, then maintain that weight for at least 6 months, before they would approve the surgery. He stated arm or leg skin surgery would not be covered but Tummy Tuck was. I was hopeful to hear this although I have not gone through the process yet to vet the accuracy. I’m sure it depends on your specific insurance plan benefits and worth a call.

[carlacv 27]

thank you!!! gonna start calling on Monday to see if this is possible and will also keep you updated

[sillykitty 10,774]

Insurance will usually cover a panniculectomy, not a Tummy Tuck. But you'll have to have documented rashes/infections. There might also be a requirement that your pannus hangs down a certain amount

[Candigrl1 152]

On 7/16/2023 at 4:13 PM, sillykitty said:

Insurance will usually cover a panniculectomy, not a Tummy Tuck. But you'll have to have documented rashes/infections. There might also be a requirement that your pannus hangs down a certain amount

This is very true of Kaiser. Your pannus has to hang down pass the mons area. Kaiser did cover my panniculectomy but I upgraded to the Tummy Tuck ($5500 in San Diego) so because some of it was covered I got half off. I'm now two days postop. Hope this helps.