Does Insurance Cover Abdominoplasty Surgery?

Posted on Friday, August 2nd, 2013 by Dr. Babak Dadvand

Abdominoplasty, or tummy tuck, surgery makes a dramatic difference in a person’s body. It is one of the most satisfying procedures I perform as a plastic surgeon. One of the main questions patients ask during the consultation is whether insurance would cover the procedure.

For most patients who require an abdominoplasty, there is some loose skin and excess fat as well as loose muscle (known as rectus diastasis). In general, insurance companies do not authorize these procedures as they deem them cosmetic and not medically necessary.

There are a subset of patients who have a significant amount of excess skin and fat, called a panniculus. These patients typically have symptoms of skin breakdown, rashes, and lower back pain that is attributable to the excess skin. In these select cases, insurance may cover the surgery but the amount of excess skin and fat must meet certain requirements. Typically, the panniculus must hang down lower than the patient’s groin in addition to causing one or some of the other symptoms. Typically a pre-authorization letter and photos are submitted to the insurance company.

To learn more about abdominoplasty surgery and to see before and after pictures visit my website at drdadvandplasticsurgery.com.

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