Does Insurance Ever Cover a Tummy Tuck?

There are significant life events that can negatively affect our body, particularly our midsection. Pregnancy, major weight loss, aging, and surgery in the area can affect the look and feel of your abdomen. And sadly, they cannot be addressed by exercise and diet alone.

A tummy tuck procedure in San Diego can solve these issues by targeting loose abdominal muscles, mild to significant skin laxity, and excess fat. It can even simultaneously remove stretch marks located below the navel.

Insurance Coverage For A Tummy Tuck

Even though most private insurance companies do not cover tummy tucks, you might be surprised to find out that Medicaid and Medicare may cover some costs of your surgery. However, if your need for the procedure is purely for cosmetic reasons, your insurance will never cover this.

Since a tummy tuck is usually considered elective cosmetic surgery, you will have to prove to Medicare that it is a medically necessary procedure. Medical necessity means that your loose skin gets in the way of performing your daily activities.

Medicare requires that you have a stable weight for at least six months. Moreover, you should explore other ways to address your loose skin in the abdomen for at least three months. You should make sure that your progress is documented by a physician who will then recommend the surgery.

Just like Medicare, Medicaid may also cover a portion of your tummy tuck surgery if excess abdominal skin after a massive weight loss negatively affects your daily life. It also requires documentation from a surgeon who can prove that you have had any of the following:

1. Pain in the abdominal pannus and/or lower back
2. Impaired ambulation
3. Interference with personal hygiene
4. Signs and symptoms of panniculitis
5. Large redundant fold of skin and fat hanging below the groin
6. Recurrent intertrigo to the overhanging pannus resulting in skin infections
7. Body Mass Index greater than thirty (30)
8. Presence of lymphedema, abscesses, or hernias
9. Documentation of size and configuration of pannus as evidenced in photographs.

The tummy tuck procedure has two phases. Your surgeon will contour your belly by tightening the underlying abdominal muscles. Then, they will remove excess skin to make your midsection appear and feel firm. Only the second phase will be covered by insurance as loose skin exposes you to risks of rashes and infection. Frequently, insurance coverage is limited to a panniculectomy alone. This involves removing the excess lower abdominal skin only. It is important to find a provider who contracts with Medicare/Medicaid to see if you are a candidate. Marin Aesthetics does not partner with either of these programs.

How Much Does A Tummy Tuck Cost?

According to the most recent statistics released by the American Society of Plastic Surgeons, the average cost of a tummy tuck procedure is $6,154. This excludes the costs of anesthesia, the operating room, and other related expenses.

In the La Jolla and San Diego Areas, the procedure can cost from $12,000 to $15,000. This will depend on the qualifications of your surgeon, the type of tummy tuck procedure, the anesthesia used, and the surgery site.

Tummy Tuck Procedure Made Easy

The majority of insurance providers do not typically cover a tummy tuck, as it is considered a purely cosmetic procedure. But Medicare and Medicaid can shoulder a portion of your procedure, provided that you can prove with proper documentation that the surgery is medically necessary.

Marin Aesthetics still wants you to reach your body goals, regardless if it is for medical or aesthetic reasons. We offer flexible payment options for a tummy tuck for you to have a well-toned midsection. We will discuss with you to come up with a payment plan that will make the procedure easier for you to avail of. Book an appointment with us to find out more!

We have partnered with CareCredit, which has a long history of cosmetic surgery. Their payment structure is much like a credit card that can offer terms from six to 24 months. Approval is quick at CareCredit, and they offer no-interest financing options!

Alphaeon Credit provides the widest array of payment options to help you reach your beauty goals. The Alphaeon Credit card keeps you moving without any delay. You can finally receive the procedure that the surgeon recommends with the easiest and most flexible payment options.

*The content in this blog is developed to spread the awareness towards plastic surgery. Our blog is not intended to serve as a replacement for an actual in-office consultation with Dr. Marin. As such, the information within this blog reflects the unique cases of our individual patients.