Are in that any insurance companies that will cover abdominoplasty ?

Answers: You need to take copies of adjectives the letters from the docs, and appeal again, and send a complaint message to your state insurance commissioner.

You ALSO need to go ahead and enjoy this done, and worry about how to reward for it later.

It boggles my mind when people hold a life threatening situation, but refuse to pocket the chance to pay for it themselves - they'd a bit die, than pay for their own medical care. Source(s): agent, 21+ years
If you attain your doctor(s) to write letters to the insurance company stating that the procedure is medically necessary - including the danger if it is not done - the insurance company will reconsider. It sounds like they are seeing "cosmetic surgeon" and react without thinking, which insurance companies are very perfect at doing.
Ok, here is what I found about your problem on Aetna's website, which probably isn't what kind of insurance you enjoy, but it still gives us a general hypothesis of how insurances view your condition. It looks like to me, what you are need is a "ventral hernia repair", not an abdominoplasty. Insurances see the word "abdominoplasty" and say, nope, that's a cosmetic surgery. So have your dr's remove that word from the papers requesting an appeal. It looks similar to insurances will cover this as long as its medically necessary and not just for a cosmetic intention. And according to Aetna, they won't cover it just based on the reality that it "might" happen because there is no evidence that have the muscles separated definitely cause a hernia. They won't repay for it if your abdominal muscles have separated and it only looks similar to a hernia is protruding, but it really isn't a true hernia. Towards the bottom, it says what has to be documented by your dr. within order for them to pay for it such as the size of the hernia, whether or not surgery would know how to reduce it, etc. I'll just copy and soft mass all the info below and you can see for yourself. It looks like to me, your insurance will probably clear for it if your doctor uses the right wording. But you need to get them to obtain "abdominoplasty" off the form. Good luck to you and I hope this helps!


Clinical Policy Bulletin:
Abdominoplasty, Suction Lipectomy, and Ventral Hernia Repair


Number: 0211


Policy


Aetna considers panniculectomy medically important according to the following criteria:

Panniculus hangs below the level of the pubis; and
The medical documentation document that the panniculus causes chronic intertrigo (dermatitis occurring on opposed surfaces of the skin, skin irritation, infection or chafing) that consistently recurs over 3 months while acceptance appropriate medical therapy, or remains refractory to appropriate medical therapy over a spell of 3 months.

Aetna considers panniculectomy cosmetic when these criteria are not met.

Aetna considers panniculectomy experimental and investigational for minimizing the risk of hernia formation or recurrence. There is no adequate evidence that pannus contributes to hernia formation. The primary lead to of hernia formation is an abdominal wall defect or weakness, not a pulling effect from a voluminous or redundant pannus.

Aetna considers repair of a true incisional or ventral hernia medically necessary.

Aetna considers repair of a diastasis recti, defined as a thinning out of the anterior abdominal wall fascia, not medically necessary because, according to the clinical literature, it does not represent a "true" hernia and is of no clinical significance.

Aetna considers abdominoplasty, suction lipectomy, or lipoabdominoplasty cosmetic.



Background
In charge to distinguish a ventral hernia repair from a purely cosmetic abdominoplasty, Aetna requires documentation of the size of the hernia, whether the ventral hernia is reducible, whether the hernia is accompanied by pain or other symptoms, the extent of diastasis (separation) of rectus abdominus muscles, whether within is a defect (as opposed to mere thinning) of the abdominal fascia, and department notes indicating the presence and size of the fascial defect.

Abdominoplasty, prearranged more commonly as a "tummy tuck," is a surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can increase cosmesis by reducing the protrusion of the abdomen. However, abdominoplasty is considered by Aetna to be cosmetic because it is not associated with functional improvements. Source(s): http://www.aetna.com/cpb/medical/data/20…
Insurance companies are operated by your fellow humans. It is they who don't care.

Call your state's Department of Insurance and ask for their assistance. I hope your company give in.

mbrcatz had no business man critical of you. That is a poor trait. Source(s): agent
Insurance companies see it as elective. If there is one that does not your doctor would have a better grasp. But you can not of late sign up for insurance and then get an operation. It is not designed to work that passageway.

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