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Tummy-tuck included (Medicaid)



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I am meeting with the surgeon pre-op on Monday. I need to explore the correct keywords to use in conversation. The goal is to have him understand to send away for insurance authorization for a Tummy Tuck to be included in the initial surgery. I need to explain it as a medical necessity. It is. Having given birth several times, I struggle with fighting rashes and infections every summer. I cannot even fathom how much worse it would get with the weight loss post-op. Thank you.

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You want a Tummy Tuck at the same time as the bypass?

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Medicaid might pay for the partial abdominoplasty, under certain conditions. But they won't pay for a Tummy Tuck. Basically they may remove the skin, but wont pay to have the muscles moved up and 'tucked'. also, you have to have lost over 100 pounds in addition to the recurrant infections. At least, this is what I have learned in the researchI've done for my mom.

Good luck.

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All insurances have different criteria (if they will pay for it at all). Some also require a certain time period following weight loss that your weight must be stable before considering skin removal. I think mine is three months but some insurances may require a longer maintenance. Mine also requires medical documentation of skin rashes/infections. Now that I'm in the maintenance phase of WLS I'll have to photograph every rash and see my doctor each time it happens to prove a problem exists before my insurance will approve it. I've had a problem with rashes every year since my first pregnancy stretched my skin beyond it's ability to bounce back (I had full-term twins). That was 28 years ago. I'm just waiting on the hot weather for them to appear again...

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Wow, that's very helpful. I'll begin to focus on documenting, rather than 'splainin' till I am blue in the face. Thank you so much.

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It's unlikely that they'd do a tuck at the same time as the bypass since there would be little point. I also doubt you could get the authorization until they can assess just how much it hangs. You never know what you body is going to look like.

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