Clinical Policy Bulletin:
Abdominoplasty, Suction Lipectomy, and Ventral Hernia Repair
Number: 0211
Policy
Aetna considers panniculectomy/apronectomy medically necessary according to the following criteria:
The medical records 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 receiving appropriate medical therapy (e.g., oral or topical prescription medication), or remains refractory to appropriate medical therapy over a period of 3 months.
Aetna considers panniculectomy/apronectomy cosmetic when these criteria are not met.
Aetna considers panniculectomy/apronectomy experimental and investigational for minimizing the risk of hernia formation or recurrence. There is inadequate evidence that pannus contributes to hernia formation. The primary cause of hernia formation is an abdominal wall defect or weakness, not a pulling effect from a large or redundant pannus.
Aetna considers repair of a true incisional or ventral hernia medically necessary.
Aetna considers abdominoplasty, suction lipectomy, or lipoabdominoplasty cosmetic.
Background
In order 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 there is a defect (as opposed to mere thinning) of the abdominal fascia, and office notes indicating the presence and size of the fascial defect.
Abdominoplasty, known 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 improve 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
Yes. If you physician in consultation with the insurance company agree that this is medically necessary treatment for your illness then depending on the type of policy you have it will most likely cover the procedure. This type of Liposuction is not a cosmetic surgery.
No. Elective surgery isn't covered. A treadmill would be cheaper.
Yes I think so
No, cosmetic procedures such as liposuction are not typically covered by insurance. Liposuction in particular is considered to be an elective surgey, not one that someone must undertake for health reasons.
Typically no, in less it's for health issues.
Liposcution prices mostly likely will not be impacted by health insurance. Many liposuction procedures are considered cosmetic and not required for the overall health of the patient and therefore not related to health insurance.
The only way to find funding for liposuction is to turn to your health insurance company. The other way is to turn to a credit loan. This will allow you to get the money without liposuction.
HBA health insurance has not currently released a statement on which industries they cover, although their overview suggests that they cover anyone who chooses HBA health insurance to cover them.
Your health insurance will cover you no matter how you got hurt. I can take a knife and stick it in my arm and go to the hospital and my health insurance will cover me. The only times your health insurance will not cover you is if you have specific exemptions in your coverage, which are rare.
Medibank offers many different health insurance plans. It offers hospital cover, extras cover, and ultra health cover. Ultra health cover combines hospital cover and extras cover.
It would be a very rare circumstance that Medicaid would cover liposuction. Liposuction is considered a cosmetic surgery, not medically necessary for the patient to have good health, functioning body, etc. If the liposuction was somehow medically necessary to address a related physical or an emotional problem, then it possibly could be covered.
Cobra insurance coverage covers health and medical needs. They are a health insurance place. They don't cover really anything but medical and health things.
Yes but it only matters on how large the scope of your unemployment insurance can cover for your health insurance.
That entirely depends on which insurance from which company.
most health insurance plans do cover transplants...but not all.