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Is There Anyway I Can Get a Tummy Tuck Covered by Insurance?

I have lost over 100 pounds and had healthy twin boys. I very steched skin. Is there any way I can get a tummy tuck insurance approved?

  1. HC Investigator
    August 28th, 2010 at 15:07 | #1
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    i have worked for 2 different ins co & neither have covered panniculectomies, tummy tucks, etc. I dont see a way around the coverage as stated in the ealier answer, unless it is fraudulently billed. as a fraud investigator, the medical records would need to compare to the billing. each claim has a procedural code (CPT) code reflecting the service. there is a code for each service and if it is billed deceptively & paid based on deception, and found later that it was not accurate then the provider could be penalized, fined, prosecuted or depending on how many times the provider has fraudulently billed, he/she could lose his license. this is * Even * if the billing clerk was the one who deceived, not the physician. You could also be charged if you were involved in the scheme. You might look into a flexible spending plan (FSA) account if you have employee health insurance. many offer FSA as well. You will probably be able to file your expenses on your FSA. we are allowed to file cosmetic procedures on ours. FSA is for the items you have spent out of pocket. Our plan has a $5000 max however each are different.

  2. Catie
    August 28th, 2010 at 15:07 | #2
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    In some cases insurance will pay, yes. A surgeon’s insurance clerk should know what avenues to take in getting the insurance to cover it. Simply call the surgeon you are considering doing the job and ask to speak with the insurance dept. Ask them what prerequisites are generally required to receive insurance payments.

  3. Custo
    August 28th, 2010 at 15:07 | #3
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    Probably not. Is it medically necessary? How long ago did you lose the weight? if its been recently, they will make you wait for 6 mo -1yr… For your weight to stabilize, and to allow your skin time to shrink back. then, they’ll make you try a whole bunch of other treatment, if you haven’t already. Then, if you still have the same insurance company, and still need the surgery, they might. (which is to say, after they deny the pre-approval & and you & your doc have to appeal) The only real way to find out, is to read the exclusions list in your plan document…. Or call them.

  4. withluv7
    August 28th, 2010 at 15:07 | #4
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    I have seen insurance companies cover tummy tucks if there is lower back pain.

  5. jogmaya
    August 28th, 2010 at 15:07 | #5
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