Question:
what are chances of insurance coverage for tummy tuck
I am five months out of RNY and have lost 81 pounds. My goal is 130, so I still have a ways to go, but was wondering if anyone that has had a tummy tuck had any trouble getting insurance to cover it. I can't wait to have a smaller stomach! — deechrist (posted on February 10, 2008)
February 9, 2008
sorry, wasn't finished. It cost $16,000.00 already I am glad I did it. I
figured this way I paid more than that for a car. I am worth more than a
car and was in a time in my life that I was able to do this for me. So, if
you are able consider it. But before you do do it, make sure you have lost
all the weight that you want to cause if you do it and still want to lose
you will end up with saggy skin again. Also, if you are at a weight that
you want to stay at waite at least 3 mos or so to make sure your weight has
leveled off.
Best of luck to you.
Niecie
— niecie54
February 9, 2008
My surgeon does not recommend any "tummy tucks" or other plastic
surgery until you have stabilized, which is about 2 years post op. This is
to make sure your body has settled in to it's new size. Secondly, plastic
surgery is up to your insurance company. Most do not pay for it. BUT, if
you have medical issues, such as rashes or infections or it impedes your
mobility, then you have a chance for partial payment. What happens is that
you have your doctor write up a need for the surgery, based on medical
conditions. You send it for approval from your insurance company. They'll
probably deny it. But they may approve removal of the excess skin, but it's
not pretty like plastic surgery. What you can do at that point, is to
consult a plastic surgeon. He can "segment" the surgical
procedures, and contact your insurance carrier about paying for a portion
of the procedure, based upon their intial approval of skin removal. This
scenario has been discussed at my bariatric support groups, and and also
mentioned by a guest speaker who was a plastic surgeon. This would be for
excess skin removal, such as abodomen, arms, or thighs. I doubt they would
cover breast reconstruction, as they would probably deem that stictly
cosmetic. DAVE
— Dave Chambers
February 9, 2008
Hi - I ended up escaping out on my first section of my reply. This is the
beginning from sorry I didn't finish.... I am 1 yr 4 mos out and have lost
115 lbs. I just recently had plastic surgery. I had my arms done (bat
wings) and my stomach and backside done. It cost me $16,000.00 and the
insurance did not cover any of it. I was told that if you can prove that
you have a rash and it is documented with your PCP and can prove that you
tired medications to try and clear it and didn't work then you have a good
chance of the insurance of kicking in. If you are in a position where you
can afford it GO FOR IT. You're worth it. But just make sure you are
maintaining. I waited 3 mos. Also read about it. I bought the book
"Lower body lift." Just educate yourself and shop around for a
plastic surgeon. They all are not the same.
Best of Luck
Niecie
— niecie54
February 10, 2008
HI! I am 3 years post op and have lost 225lbs. I have alot of extra skin
and my back problems have gottens worse. I went thorough the insurance the
fst time they denyed it. I submited it again and I have pics and documents
from docs and again they denyed because they lost the pics. So here we go
for round three and this is the last time I can appeal so we will see. I
will need to have a full body lift, breast lift, and my legs done. I wish
you luck! It is worth trying to have it paid but be prepared that it may
take a while and a lot of effort Feel free to email me on my profile if you
have any quetions.
— DD102205
February 10, 2008
Hello I am 3 years out almost and I have 15 pounds I want to lose from my
baby. I am not having any more kids and my weight is pretty much done. I
have medical issues like rashes and yeast infections in my belly button so
mine might be covered but I do not know for sure. When I find out if you
are interested in knowing then I will let you know but it is always
medically necessary that you will get insurance to cover it.
— tl_morgan
February 11, 2008
I am 4 1/2 years post RNY. My insurance would not pay for my tummy tuck
but my income tax refund did!!! I just had mine done in August 2007. Best
thing I ever did. It cost $9,500. I also got new boobies and the Dr threw
in some lipo for free. Definately money well spent!!!
— Carlyn M.
February 11, 2008
You need to have medical necessity and be at least probably two years out
to prove you have maintained your weight.
— tl_morgan
February 12, 2008
My medical insurance covered my WLS and 2 years later, covered an
abodominalplasti. You will probably have to wait since you've only been
out for 5 months??? every provider/surgeon is different...but, if u say u
want/need one due to rash, and/or other "problems/concerns"...
chances are greater for coverage. Good Luck! Laxi
— 502Laxi
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