How To Get a Tummy Tuck Paid For by Insurance
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Summary:
Most health insurance companies will not cover a full tummy tuck because it’s often considered a cosmetic procedure. However, if your physician believes the procedure is medically necessary, your insurance may pay for a large portion of your tummy tuck.
A tummy tuck can improve your posture and make a huge difference in how you feel about your body and even how well your clothing fits. It’s little wonder, then, that this is one of the most popular cosmetic procedures on the market. If you’re one of the many people who feel uncomfortable with the excess skin on their stomach, you may have considered getting a tummy tuck yourself.
In most cases, a tummy tuck surgery is considered a fully cosmetic procedure, but did you know it’s possible to have coverage for a tummy tuck approved by your insurance provider? Let’s look into the ways you can have your health insurance cover tummy tuck surgery.
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What is a tummy tuck?
A tummy tuck — formally known as abdominoplasty — is a surgical procedure that removes excess skin from the abdomen. In many cases, the procedure also tightens abdominal muscles caused by diastasis recti (separation of the muscles along the abdomen) and includes mild liposuction to even out a patient’s stomach.
Tummy tucks are typically considered cosmetic surgery and are often sought after by women who gave birth or people who underwent significant weight loss. To have your tummy tuck procedure covered by insurance, there are a few requirements you may have to meet, which we’ll discuss further on.
How tummy tucks are conducted
A tummy tuck procedure is a fairly involved process. When seeking out this cosmetic procedure yourself, here’s what you can expect.
- Consultation. Make an appointment with a cosmetic surgeon to find out if you are a good candidate for a tummy tuck procedure. You may need to pay a fee, which in most cases will go toward the surgery. During this stage, the doctor will explain the details of the surgery and the costs involved.
- Book your appointment. If you choose to go through with the surgery, you’ll then book an appointment at your local cosmetic surgery center. The doctor will give you instructions on how to prepare for your procedure.
- Surgery. The surgery will consist of two main phases. First, your abdominal muscles will be tightened through multiple incisions. Excess skin is then removed, making your stomach flatter and leaner.
- Recovery. Once the procedure is done, you’ll receive instructions for the recovery process. You’ll likely be prescribed pain medication to help with any discomfort.
- Follow-up. A mandatory follow-up visit will be scheduled. This visit will help the doctors ensure that your tummy tuck surgery went well.
How to finance a tummy tuck
A tummy tuck costs a pretty penny out of pocket, so if you’re serious about getting one, you’ll need to plan ahead. The options below outline some of the ways you can cover the cost of a tummy tuck.
- Cash. Cash is king, especially for an expensive cosmetic procedure like plastic surgery or a tummy tuck. If you can afford it, pay for your tummy tuck procedure upfront in cash.
- Medical loans. If you need any type of medical procedure that won’t be covered by your insurance company, medical loans can be a good alternative to cover those costs. You can take out a medical loan to get the money you need at a reasonable interest rate.
- Medical credit cards. Yes, you can get credit cards specifically for paying medical bills. These cards offer more flexibility on how much you can borrow, but they often come with higher interest rates than loans.
- Payment plan. Depending on the office you visit, you might be able to get a payment plan for your cosmetic surgery. These typically come with no interest rate and are paid directly to the surgeon.
- Health insurance. Yes, your health insurance may cover a portion of your tummy tuck, but only in certain situations. It’s worth noting here that health insurance won’t cover the whole surgery, so you should still consider the above options to cover the rest of the cost yourself.
Pro Tip
Before you book your surgery, check with your insurance company to make sure your health plan covers tummy tucks for medical reasons.
How to have a tummy tuck covered by insurance
Tummy tucks are generally considered cosmetic surgery, which means (in most cases) they aren’t covered by insurance. However, there is an exception to this rule: In order to have a tummy tuck covered by insurance, you must prove the procedure is medically necessary.
What’s more, even if you do get a tummy tuck approved by your insurance provider, it’s highly unlikely they will provide coverage for your surgery in full. Although the procedure in general may be medically necessary, abdomen tightening is still considered cosmetic. This means most insurance plans that do cover the surgery will only pay for the second phase to remove excess skin.
Pro Tip
Most insurance companies will tell you upfront that your policy won’t cover your tummy tuck, but that doesn’t have to be the final word. Prepare to dispute this claim and ask your doctor to advocate for the procedure on your behalf.
What constitutes a medically necessary tummy tuck?
The following are some examples of what could be considered medical reasons to get a tummy tuck.
- You have an excess skin fold that causes rashes, breakouts, and sores. If you get frequent rashes on your abdomen due to a large skin fold trapping moisture, a tummy tuck surgery could be considered a medical necessity.
- Your stomach muscles are loose to the point of causing urinary incontinence. If you frequently wet yourself, this could be a sign that your lower abdomen needs to be tightened.
- You have difficulty walking because of loose skin or muscles in your abdomen. This is a rare condition, but if it does happen to you, your health insurer may cover a corrective tummy tuck procedure.
- You have loose abdomen muscles that cause back pain. In some rare cases, insurance companies will consider this enough of a medical reason to cover a tummy tuck.
- You have a ventral hernia. Tummy tuck procedures can occasionally be used as a form of hernia repair.
- Your doctor believes the procedure will help support your abdomen after a hysterectomy. Although it’s rare, you can get a tummy tuck covered after having a hysterectomy procedure.
Note that even in the above cases, your insurance policy will likely only cover the second phase of your tummy tuck, as that would constitute the medically necessary portion of the procedure. Still, it’s better to pay for only part of your surgery out of pocket than for all of it.
Can you get a panniculectomy covered by insurance?
Contrary to abdominoplasty, a panniculectomy is the simple removal of excess skin without abdominal tightening. This is often done to reduce ulcers and rashes. If you can’t get a full tummy tuck paid for by your insurance company, this may be a good alternative for you.
Unlike tummy tucks, panniculectomies are usually considered medically necessary procedures. This means you’re much more likely to have your elective procedure approved by your insurance company than if you were to request a full tummy tuck.
FAQs
What are the disadvantages of a tummy tuck?
A tummy tuck may be a good option for mothers who are done with childbirth, but rapid weight gain and pregnancy can reverse all the work from the procedure. After undergoing surgery, you’ll likely have a permanent scar on your lower abdomen. Results can also take time to fully show, and recovery may be slow and painful.
What type of anesthetic is used in tummy tucks?
You will not be awake during your tummy tuck surgery. The standard protocol is to use general anesthesia.
Who would be considered a good candidate for a tummy tuck?
Tummy tucks are best for people who are close to their ideal weight, have excess skin from weight loss, and have weakened abdominal muscles. Women should also have no intention of going through pregnancy and childbirth in the future, as that can undo all the results of a tummy tuck.
What is a mommy makeover?
A mommy makeover is a set of cosmetic surgeries that are performed together or in quick succession, all with the same goal: to restore a woman’s pre-pregnancy body after she’s given birth.
The most common combination of surgeries in a mommy makeover consists of a breast lift and a tummy tuck. In some cases, it can also include liposuction around the thighs and a breast enhancement procedure.
Key Takeaways
- In most cases, tummy tucks are considered cosmetic procedures and are therefore not covered by insurance.
- Your health insurance provider may be willing to cover a tummy tuck if it is medically necessary.
- Medical reasons for a tummy tuck include rashes from excess skin, hysterectomy support, and urinary incontinence due to weak abdominal muscles.
- Insurance coverage can vary greatly from company to company, so check ahead of time to see if your policy covers tummy tucks for medical reasons.
- To get a medically necessary tummy tuck, you may need your doctor to advocate for the procedure on your behalf.
- In the majority of cases, a tummy tuck will only be partially covered by health insurance, so it’s best to have a plan in place to cover the rest of the cost yourself.
Get the best coverage for your medical procedure
From vasectomies to LASIK to chiropractic care, health insurance covers a wide variety of treatments. But insurance plans can be difficult to navigate, and not all insurance policies will necessarily be a good investment.
If your health insurance won’t cover all or most of a major medical expense, you still have options. Start by checking out SuperMoney’s guide to medical financing. Interested in elective procedures that your insurance plan likely won’t cover? Read our guide on elective medical loans and use our comparison tool to find the right personal loan for you.
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