How to Get a Tummy Tuck Paid for By Insurance
Tummy tucks are typically considered cosmetic and elective surgeries because they are rarely seen as medically necessary procedures that will either save your life or improve your quality of life. In the vast majority of cases, cosmetic and elective procedures are excluded from health insurance policies.
Now, you may be wondering about cosmetic insurance plans, which sound like they might end up paying out for a tummy tuck. However, cosmetic insurance policies are designed to pay for medical expenses that arise after a cosmetic surgery.
Tummy Tuck With Medicaid
Tummy tucks are surgical procedures that use liposuction to remove abdominal fat and skin, tightening abdominal muscles for a more youthful appearance. They are commonly performed on women who have had children or have lost weight quickly. The surgery can be performed under general or spinal anesthesia and usually takes about two hours. The cost of tummy tucks varies depending on location, insurance coverage, and other factors. The average cost is around $8,000, with experts suggesting it should be closer to $5,000-$6,000. Additional procedures like breast lifts or implants may be required for cosmetic overhauls.
In 2016, the average cost for a tummy tuck was $5,775 in the United States, which is more than a year’s tuition at some community colleges and universities. Medicaid can help individuals afford tummy tucks without paying out-of-pocket. However, if a state offers Medicaid breast reduction surgery, breast augmentation, and reconstruction surgeries, Medicaid may cover the procedure. As long as the medical condition warrants Medicaid coverage, the procedure may be covered by Medicaid.
Will Medicaid Pay For Panniculectomy
| Aspect | Details |
|---|---|
| Medicaid Purpose | Designed for medically necessary situations. |
| Examples of Coverage |
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| Tummy Tucks | Typically considered cosmetic; not usually covered by Medicaid. |
| Possibility of Coverage | Can be covered if medically necessary; requires explanation to insurers. |
| Insurance Inquiry | Must explain necessity and quality of life improvement. |
| Cost Range | $5,000 to $15,000 depending on surgeon and location. |
| Medical Necessity Criteria |
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| Panniculectomy |
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| Insurance Approval Requirements |
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| Choosing a Surgeon |
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| Preparation Steps |
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| Procedure Overview |
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| Post-Operative Care |
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Can A Tummy Tuck Be Medically Necessary
Tummy tuck surgery is primarily an aesthetic procedure designed to remove excess skin and tighten underlying abdominal muscles. It is often sought by pregnant women or those who have lost significant weight. If sagging midsection skin prevents daily activities, tummy tucks may be an ideal solution. However, there are medical reasons for tummy tuck surgery, which can vary based on each patient. Diastasis recti, a loose abdominal muscle caused by pregnancy, can be treated with tummy tucks. Hernias, caused by pregnancy and childbirth, can be repaired with tummy tucks, preventing further complications. Back pain, caused by heavy abdominal skin, can be resolved by restoring mobility and making the patient feel comfortable in their body. Recommendations for tummy tuck surgery vary based on each patient’s individual needs. Dr. Morales can help patients feel confident about their decision during their assessment.
Other Tummy Tuck Benefits
Morales Plastic Surgery specializes in tummy tuck surgery, which allows patients to address multiple areas at once. Recovery after a tummy tuck involves avoiding strenuous activity for 1-2 weeks, including heavy lifting and sexual activity for 6 weeks. Returning to work in about 7 days is possible, but it’s important not to stand or sit for extended periods of time. Pain medication prescribed by the doctor may include aspirin, ibuprofen (Advil or Motrin), or another NSAID. Alcohol and smoking are also advised as they can increase bleeding and constrict blood vessels, making healing slower and more difficult.
Recovery from a tummy tuck involves avoiding strenuous activities for 1-2 weeks, such as heavy lifting and sexual activity for 6 weeks. Pain medication may be prescribed, and it’s essential to avoid alcohol and smoking. If there is drainage from the incision site, do not squeeze or rub it to prevent infection.
Tummy tucks are associated with risks and complications, including infection, bleeding or blood clot formation, scarring, early separation of stitches due to pregnancy or weight gain, and scarring and early separation of stitches due to stretching during pregnancy or weight gain after surgery. If you experience any of these symptoms, call your doctor immediately.
Medicaid does not cover tummy tucks, but there are steps patients can take to get the procedure covered under Medicaid. First, it’s important to know what counts as a “medically necessary” procedure: procedures required to treat an illness or condition expected to last at least three months, or surgery performed to improve function or appearance.
In summary, tummy tuck surgery offers numerous benefits, but it’s crucial to consult a doctor if you experience any complications or concerns.
