Tummy Tuck- can it be covered on health insurance?

[sleepysox]

I know of someone who got a TT on the NHS (but don't know any exact details). I was wondering if you knew if it was possible to get one if it was a medical need? We've got health insurance so wouldn't be using NHS resources.

My baby was born with hydrocephallus amongst other things, plus I had gestational diabetus, so I was very large for dates and also DS's head was too big for me to deliver naturally. His head was off the scale when they measured it when he was born. So my stomach muscles stretched massively through carrying him, and despite me doing the Tupler Technique exercises, there is still a 4 finger width gap between them. I now have permanent back ache as my core muscles are ineffective. So I was wondering if this was a medical need to get one done.

Does anyone have any info, even if it's just anecdotal?

Hope someone can help

[strawberryjelly]

Easiest way is to phone your insurance provider. if your GP can say that the problem is causing you physical or psychological distress then i think the answer is yes.
I have private insurance and have used it for all sorts but it all begins with a referral from your GP.

[Librashavinganotherbiscuit]

Have a read of this thread
Have you seen a physio? That might be the next step before surgery.

[sleepysox]

Thanks for the link Libra, I have Julie Tupler's book, and also the splint she recommends and have been doing the exercises. The gap has got smaller, but never closes completely. Probably because DS is 13kgs and is not walking and has low muscle tone and so is very heavy and so my muscles separate again when I lift him. Ideally I should wear a splint all the time to carry him, but that isn't practical eg when I collect him after work etc. Plus his special needs buggy is very heavy to lift and set up.

I haven't seen a physio. I think after reading your post that that should be my next step and then if my stomach muscles haven't got flattened by the time DS is at school, then I could consider surgery.

It's good to know strawberryjelly that if my GP can back me up, there might be a chance I can get a TT using my insurance.

Thank you both for replying :)

[tulpe]

I had part of my tummy tuck covered by my insurance but the BMI hospital I used charged for two separate ops: the tummy tuck itself (being cosmetic) and the hernia/muscle repair (being medical need). So basically the hospital got paid twice in effect as they argued that each part of the op was a distinct procedure and required anaesthetic/theatre time irrespective of the other.

So basically I ended up paying the same for my procedure as if I hadn't made the claim. Bizarrely, if I hadn't have made the claim, the hospital would have charged me for one procedure only. Stupid, and I still cannot understand how they got away with it.

Your insurance may be different but our insurance is very comprehensive and covers us for all kinds of weird and wonderful things so it wasn't a shortfall on cover.

Like you, the Tupler method didn't completely work for me and the physio and my osteopath couldn't improve matters either. I was otherwise fit and healthy and worked out a couple of times a week, together with running and swimming. After being unable to walk or drive for 6 weeks when my pelvis dislocated (due to weak core stability caused by separation) I decided enough was enough and I went ahead with the op. It has made a huge difference to me and I rarely if ever experience lower back pain now.

[sleepysox]

Thanks Tulpe. I'll check my insurance cover. I keep getting bouts of what I thought was SPD- could this be linked to my DR?

It's shameful the way the hospital was able to charge twice and you ended up paying the same amount.

I'm so glad the TT has worked for you. HOw long was your recovery time?

I run 3 times a week, and walk lots pushing the pram, so think I'm fit. I'm a stone overweight though, so I need to lose that

I don't want to look like a supermodel or even look thin. I just want the back pain to go and not look like I'm 6 months pg!

[Librashavinganotherbiscuit]

It's not about being "fit" your core muscles are shot to shit and that is what needs to be repaired, running and pushing a buggy aren't going to do that. For most people specific exercises will do this but in some extreme cases then surgery will be needed.

[sleepysox]

Thanks Libra. I've shortlisted some physios and hope to ring them on my day off. I really hope it works. I don't think exercises will help tighten all the loose skin too or will they?