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