In general, abdominoplasty procedures are usually elective or cosmetic procedures. Such procedures are likely not eligible for insurance coverage. Patients with epigastric umbilical, ventral, or incisional hernia may be able to receive coverage for this portion of the surgery.
It is vital that a general surgeon be present during the functional part of the operation to repair the hernia. Generally, full disclosure of hernia and the cosmetic part of the procedure will be described through the insurer.
Issues to Contemplate
Enormous panniculectomies, which refers to large abdominoplasties on patients who have received gastric bypass procedure will, at times, be covered by insurance if there are functional issues including back pain, and rashes and dermatitis beneath the large pannus, after massive weight loss.
Plastic surgeon Dr. Paul McCluskey provides tummy tuck surgery to patients in Atlanta, Buckhead, Georgia, and surrounding locations.
What is Panniculectomy
Significant weight loss is a healthy approach for people who are suffering from obesity. However, the excess skin that remains after the weight loss is not healthy. The excess skin may be heavy enough to lead to physical pain.
It can impact mobility, restrict physical activity, and affect personal hygiene. Skin folds may become tender and prone to yeast infections. Panniculectomy is a surgery to eliminate the excess skin that remains after major weight loss.
The patient may be able to receive insurance coverage for this procedure as it is considered reconstructive when it is undertaken to correct or relieve physical symptoms. But the law is still evolving around this issue.
A few years ago, insurance companies offered coverage for a panniculectomy. Subsequently, they decided that it was an issue of one’s own making and started denying coverage for this surgery.
After the American Medical Association classified obesity as a disease, states started requiring insurers to offer coverage for the procedure once again.
Other Specific Cases where Tummy Tuck may be covered by Insurance
Panniculectomy is a procedure that eliminates only excess skin. On the other hand, a tummy tuck (abdominoplasty) involves the removal of excess skin and fat from the abdomen area as well as a tightening of the underlying abdominal muscles.
A woman may feel like they need a tummy tuck following pregnancy, especially if their expanding belly causes the abdominal muscles to separate vertically, in a condition called diastasis. But insurance does not offer coverage for diastasis repair, which is considered by the medical profession as strictly cosmetic.
An abdominoplasty may be eligible for insurance coverage, but when it is undertaken as a part of breast reconstruction.
For instance, in what is called a DIEP Flap procedure, the surgeon will use fatty tissue and skin from the abdomen to replace the tissue and skin removed from the breast during mastectomy, which results in a natural, soft, reconstructed breast.
The blood vessels in the lower abdomen, right underneath the skin, are used in SIEA Flap surgery. Regardless of the approach, the contour of the abdomen can be improved and smoothed through a cosmetic abdominoplasty.
Patients should ideally discuss with their insurer beforehand in case of an abdominoplasty. The surgeon’s staff may be able to offer the patient information and assistance on the insurance documentation and formalities.
Patients who do not receive insurance coverage for a tummy tuck procedure may be able to pay for their surgical procedure using major credit cards.
They can also use various financing options to pay for their abdominoplasty, including financing from medical care financing firms providing loans exclusively for medical purposes.
These companies usually provide more competitive interest rates, faster loan approvals, and easy monthly installments of up to 60 months. Cosmetic surgeon Dr. Paul McCluskey receives patients from Atlanta, Buckhead, Georgia, and nearby areas for a tummy tuck.
Serving patients in and around Atlanta, Buckhead, Roswell, Marietta, Georgia and surrounding areas.