American Society of Plastic Surgeons
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adelaney
one year ago
Answered

Insurance is covering panniculectomy. Can I pay the difference for TT?

My insurance is covering a panniculectomy due to infections from weight loss after c section 3 years ago. I’ve heard of surgeons billing the insurance company for the panni and then bill the patient for the difference. The surgeon I spoke to does not do that and if I got a tummy tuck it would cost almost $12,000. I’m looking for a surgeon that will do that and I’m willing to travel if necessary.

Procedure: Tummy Tuck
Type: Question

Replies 9

Gregory Baum
ASPS Surgeon

Thanks for your question. I will sometimes try to get a panniculectomy covered by a patient’s insurance and then the patient pays for the tummy tuck if desired. Your quoted price of $12,000 seems high for a standard tummy tuck. There is no need to travel outside of Syracuse as there are several well-trained, board-certified plastic surgeons in the area. Best wishes always.

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Larry Weinstein
ASPS Surgeon
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Panniculectomy covered by insurance should cover a substantial part of your procedure. The tummy tuck portion could be as little as 7500. You would need to be seen in consultation before arranging operating room time. Good luck. .

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Debra Johnson
ASPS Surgeon
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First, you would need to talk to customer relations at your insurance and see if they are amenable to your combining a "cosmetic" procedure to your panniculectomy. Then your plastic surgeon would need to figure out for you what the difference in his/her surgeon's fee would be for the added surgery. Finally, you would be responsible for the additional Operating Room and Anesthesia time. Some surgery centers are so pricey that adding additional cosmetic procedures is too expensive. You need to speak to the surgery center and get a fee quote in writing, so you know up front what you're in for. Sometimes it's less expensive to just pay for the whole abdominoplasty and have it done in the doctor's private operating suite.

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Malcolm Roth
ASPS Surgeon
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If your panniculectomy is covered by your insurance carrier and you are a reasonable candidate for simultaneous abdominoplasty, your out of pocket cost would probably be significantly less than the amount you were quoted if there are no other procedures that you want at the same time.

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John Obi
ASPS Surgeon

It is somewhat routine for a patient that is having a panniculectomy to elect to have a full tummy tuck. Typically the facility and anesthesia provider will bill the patient for the additional time required to perform the additional procedure and the insurance company is billed for the panniculectomy portion.

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Edward Domanskis

Yes, we do that quite often where there would be a charge for the TT part and we bill your insurance. We would have you submit photos and we would write your insurance carrier to get you pre-authorization. You can contact my patient coordinator rachelle@surgery-plastic.com and send photos.

Dr. Edward Jonas Domanskis is Certified by the American Board of Plastic Surgery

Newport Beach, San Francisco,Miami, EU, Anguilla

Assistant Clinical Professor of SurgeryWOS-Plastic,University of California (Irvine)

Orange County’s Physician of Excellence/America’s Top Physicians/Top Doctors

Plastic Surgery- 2005-2018

President,American Society of Bariatric Plastic Surgeons

Organoderm Skin care/ScaRxTape

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Richard Greco
ASPS Surgeon
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Good Question

First you should have an evaluation by a local board certified plastic surgeon near you.

Are you a good candidate for the procedure that you are interested in?

Once the correct operation is chosen, most plastic surgeons can help you work out the financial details.

Typically, one applies to the insurance company for approval for a panniculectomy. One has to have the appropriate symptoms and physical findings , and your policy not having it excluded to get them to agree to covering the procedure. This is not as easy as you think.

Most plastic surgeons have the ability to charge you for the additional cosmetic portions - Muscle tightening, additional upper abdomen elevation and soft tissue and skin resection, and possibly liposuction - and get you a cosmetic fee for the extra OR and Anesthesia costs.

I agree, that in many parts of the country, you could have a cosmetic tummy tuck for less than you have been quoted.

Good Luck

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Nelson Castillo

Thank you for sharing your excellent question. It is possible to pay the balance of a tummy tuck operation after reimbursement from your insurance company for a panniculectomy. Hope this helps.

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Elizabeth Morgan

I am sorry your surgeon will charge you full price for doing the panniculectomy if you want the tummy tuck but if that is his policy, then you need to look for a new Board Certified Plastic Surgeon. Just call their offices, explain your situation and ask what their policy is for combined insurance/cosmetic surgery. Good luck!

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