Would insurance partially pay if I have a hernia fixed and a tummy tuck?

Q:

Have you worked with a general surgeon at the SKC surgery center to fix a hernia and give a tummy tuck? Or have you had insurance pay for part of surgery before, if you have fixed the hernia?

A:

Thank you for this question. As time has passed insurance carriers have become much more attentive to cosmetic surgery performed at the time of reconstructive procedures such as a hernia repair & Tummy Tuck. Many will totally disallow coverage for any services provide if both types of procedures are performed at the same setting. This means that you could be held responsible for all the costs associated with your hernia repair and Tummy Tuck. 

 

 Consider first checking with your insurance carrier to see if they will allow such combined procedures (Cosmetic & Reconstructive Surgery) to occur at the same setting/ time. Our experience has shown that even if the insurance carrier states it is OK that latter they reverse their option/ decision. We refuse to take the risk of eventual non-payment for services rendered. Best,

 

Gary R Culbertson, MD, FACS

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