When Does Health Insurance Cover A Tummy Tuck?

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   Marlin McKelvy

   President, Consumer Directed Benefit Solutions, Memphis, Tennessee

   As a general rule, a "tummy tuck" is viewed as cosmetic surgery and is not covered by health insurance polices.  However, obesity is becoming an increasing problem in our nation.  This has resulted in a growing number of people who have reached health or life threatening levels of morbid obesity for which they have had either prescription and/or surgical treatments that result in extreme weight loss.  In some cases the weight gain has stretched the person's skin to such an extent that after their extreme weight loss following treatment their skin does not return to normal levels and the person is left with folds of skin which can, in some cases, become sources of medical problems themselves (e.g. - severe rashes and infections).  In these extreme circumstances the insurance company may agree that it is an issue of medical necessity that this issue be surgically addressed and the will approve coverage for the removal or lifting of this excess skin tissue.  This has been the only circumstance where I have seen an insurance carrier approve what might be construed as a tummy tuck.

   Answered on July 26, 2014

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