There is no doubt that cosmetic surgery is expensive, and as abdominoplasty is almost entirely cosmetic in nature, the bulk of the cost will fall on the patient seeking the surgery. There are a few times, however, when medical insurance may help to cover the costs of the surgery should the patient meet specific medical criteria.

Prior to the surgery, the patient should consult with the surgeon to see if any of these conditions are obviously present prior to the procedure. The patient and surgeon would then work with the insurance company to determine the amount of eligibility and provide a letter of predetermination by the insurance company if necessary to ensure all of the insurance requirements are in place prior to the surgery.

Muscle Separation

Excessive muscle separation can be considered a medical problem rather than a cosmetic one in some conditions. Repairing the muscle wall may be covered in certain insurance policies and determining this is done usually prior to the surgery and must be investigated ahead of time to be effective.

Hernia

If the muscle separation has occurred drastically, a hernia may have been produced. A hernia is a breach of the muscle wall by underlying tissues and it can be painful or the patient may be oblivious to the hernia until the surgeon uncovers it on the day of the surgery. A hernia is a medical condition and the surgeon will repair the hernia as part of the overall surgery. The portion of the surgery attributed to the hernia will be subtracted from the patient’s total cost as it often not discovered until the procedure is underway following full payment.

Drooping Skin

If the looseness of skin is excessive, and it folds down onto other skin on the body, there may be a medical rationale for removing a portion of the overlapping skin. If the drooping skin is causing infections, rashes or other medical problems, it may be possible to have insurance cover a portion of the associated costs.