Hello, It has been awhile since I have posted. I have been busy with an overseas move and two little ones. Anyway, I have had 7 plus abdominal surgeries including 2 c sections and j pouch construction and this last surgery at the end of July for a liver cyst, I developed a hernia that has been bothering me. My primary dr said I have several so now I am seeing a plastic surgeon. Has anyone had any experience with something similar? I am wondering if insurance is going to pay. I am a very small person but have bulges from the hernias in my abdomen and I am very self conscious and would love to have a mini tummy tuck while they are in there to correct this. Any thoughts as to what insurance may pay? I know it depends on what all is wrong with me and my insurance company but I was wondering what to expect. thanks in advance
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I have had about 1/2dzn hernia repairs over the last 7yrs...and at least 5 abdominal reconstructions (in small doses)...
My laporoscopic surgeon does mesh repairs on me each time (I seem to spring lots of leaks in my abdomen!) but he doesn't fix the esthetic aspect (only makes it worse with all of those tiny holes...looks like I have the measles) and my plastic surgeon did one surgery with general that he mightily botched (passed it on to an intern who did only half the job) so he has been fixing it bit by bit using local anesthetic (won't let him put me under general any longer )...each time it is a bit better but face it...I am never going to look like a 20yr old with a hard body!
Sharon
ps...my insurance only covered the hernia repairs
Typically, insurance covers only that which is medically necessary, with the exception of the face (because of the significant emotional trauma associated with it). Medically necessary plastic repair usually involves the hands, feet, and joint areas.
Tummy tucks or similar surgery may be covered if the surgeon can associate a medical problem with it (like fungal infections from overhanging abdominal skin with extreme weight loss). Scar revision due to pain or restricted movement may also be allowed. It is a case by case scenario. But if it is purely cosmetic, probably not covered.
Jan 