Hernia and TT

Hello all....I had my RNY in November. I am 7 months out and have lost 80 pounds. I know I have a way to go but I am reserching for my plastics now. Once my weight stabilizes at approximately 1 year to 18 months post surgery, I would like to have my hernia repaired along with a TT. My hernia is RIGHT BY MY BELLY BUTTON. Will they try to say I need only a panni or because of the location of the hernia, will I be eligible for a TT? Medically speaking? I don't care what the insurance says. I am looking at it from a medical standpoint first. I will worry about insurance next year once I am done losing weight and maintaining a normal weight. Thanks, Deborah

Congrats on your progress !  The hernia will be covered probably, and the panni will be covered if you meet their criteris (typically 3 months of skin rashes requiring medical treatment).

I routinely fix the hernia along with the TT, and only bill insurance for it.  My patients get the hospital stay and usually an hour of anesthesia time and OR time credited that way.

Here is more info from my website on insurance coverage:

http://www.drlomonaco.com/tips-on-getting-insurance-for-plas tic-surgery.shtml

I had my TT last weekend. Only the panni portion was covered and medically necessary according to 2 different insurance companies.  That allowed my anesthesia and the hospital portion of the bill to be covered which was awesome. I only had to pay for the surgeons portion for the actual tummy tuck which was only $2700.  It might be the same for the hernia.  From what I have researched it is hard to get the insurance to consider the muscle tightening portion of  a TT medically necessary, not impossible though. Good luck and congrats on your weight loss

Whether or not a panni or TT is covered also depends on how your policy is written.  The policy my company has specifically excludes plastic surgery unless it is part of a reconstructive procedure for something such as breast cancer.