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Will insurance pay for a tummy tuck if it is more of a medical issue than a cosmetic one?

Q:

I had a C-section 18 years ago and now the flap of my fat abdomen is causing me to have fungus and infection.  I try to keep the area dry and clean, however, I am now in menopause and sweat a lot, so the area is constantly moist.  Will insurance pay for a tummy tuck in my case since it is a medical issue?

A:

Insurance companies will not pay for a tummy tuck for the problem you describe. However, many will pay for what is called a panniculectomy, the removal of the hanging flap. This procedure does not include tightening the other skin of the abdomen or the muscles. Only a full abdominoplasty does that. The only way to tell if your insurance company will pay for a panniculectomy is to ask. When you do this you need to also ask for any specific requirements and how they determine if it is coverable.

R.T. Buchanan, MD

A:

Insurance companies typically will not cover abdominoplasty surgery given your symptoms. Each insurance plan has different coverage and you should contact your insurance company for more specific information regarding coverage. Sometimes insurance coverage is possible for patients who have had major weight loss. This procedure is called a panniculectomy and is designed to remove overhanging skin.

L. DiFrancesco, MD

Lisa DiFrancesco, M.D. - View Other Answers by this Doctor
Decatur, GA

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