Will Medicare Pay for Extended Abdominoplasty?

Will Medicare cover extended abdominoplasty after weight loss? – Extended Tummy Tuck Medicare Guidelines

After significant weight loss or weight loss surgery, you may require an abdominoplasty or extended tummy tuck to remove excess skin or repair weakened abdominal muscles. While this operation is usually done for cosmetic reasons after pregnancy, it is often integral for patients to correct excess skin after surgical weight loss procedures.

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What is an extended abdominoplasty?

An extended tummy tuck or expanded abdominoplasty procedure involves a surgeon removing excess skin from the patient’s front and sides. It also improves muscle laxity at the flanks (love handles) and hip region.

The extended tummy tuck was developed after surgeons acknowledged that traditional tummy tucks (just the front overhang or pooch) improved the abdominal area but not the flanks or back. This procedure has been performed on thousands of patients, with excellent results. Placement of the extended abdominoplasty incisions is a critical skill so that scars can usually be covered up and hidden by bathers or underwear.

Will Medicare Pay for a tummy tuck?

Are you considering an extended Abdominoplasty?

Many patients feel a great deal of pressure to appear perfect. Abdominoplasty can improve your appearance and your quality of life. However, it is also a major surgery and is not suitable for everyone. If you are obese, consider if you have done all you could before surgery. This includes dieting and exercise.

In November 2018, Medicare made several changes to their benefits scheme. As a result, many procedures that Medicare previously covered, were reduced reimbursement or have been removed from coverage altogether.

Generally, Medicare does NOT cover the cost of cosmetic procedures, and some private health insurance will NOT cover it, either. However, if your abdominoplasty procedure is done for reconstructive reasons, part of your costs might be covered. You can discuss this with your specialist surgeon for more information.

Medicare will provide a modest rebate if you satisfy the weight loss criteria. You will need to demonstrate:

  • That you have had significant weight loss, defined as 5 BMI points or more
    • This must be unrelated to pregnancy
    • In women, this means a weight loss of at least 15 kgs or more without weight fluctuations in the last 6 months
  • The level of excess skin is interfering with daily living
  • Use of non-surgical treatments for skin irritation caused by excess skin, has failed to work
  • You have a hernia that can be documented in an ultrasound

Unfortunately, Medicare does not provide assistance for women suffering from muscle separation or excess skin related to pregnancy. This is despite the demonstratable, significant improvements in back pain and incontinence for women that have muscle separation repaired with a tummy tuck. The government is currently reviewing its position on this, but it is uncertain if this rule will be changed.

What do I need to qualify for extended abdominoplasty?

Before a surgeon will perform your operation, you will need to be at a stable weight. You may be asked to postpone your operation if you still have weight to lose or you plan to become pregnant. Abdominoplasty will not prevent you from gaining weight in the future.

If you are under 18 years old, you will need to undertake a psychological assessment and wait for a cooling-off period of up to 3 months before having this major cosmetic procedure. However, this will not apply if you are having surgery for reconstructive reasons.

What is the cost of extended abdominoplasty

A number of factors determine the cost of abdominoplasty surgery. These costs vary from patient to patient and include:

  • Surgeon fees
  • Anaesthetist fees
  • Hospital fees
  • Medication
  • Dressings
  • Support garments

Your surgeon will provide you with information, in writing, about the cost of your abdominoplasty. This information will include:

  • The total cost
  • Details of deposits and payment dates
  • Payments for follow up care
  • Possible further costs for revision surgery or treatment

Am I a good candidate for an extended Tummy Tuck?

An extended tummy tuck is often an effective treatment for patients wishing to refine their figure following substantial weight loss. These patients usually need help to restore tone and contours to the abdominal, hips, flanks, and back muscles and are usually suffering from excess skin. This excess skin can often weight several kilograms

An extended tuck incision spans the entire length of the abdomen and extends to the back of your hips. Your surgeon tightens muscles and creates a new navel to match your new body shape. Further, your surgeon  may also use liposuction to achieve ideal body contouring.

Once excess skin has been trimmed, the abdomen, hips, flanks and back, the incision is closed with sutures. For the best body contouring results, your surgeon may also undertake an arm lift, thigh lift, or liposuction with your tummy tuck.

Dr Patrick Briggs Specialist Plastic Surgeon

Dr Patrick Briggs
FRCS (Plas)

Specialist Plastic and Cosmetic Surgery Clinic in Melbourne

Dr Patrick Briggs is a Specialist Plastic and Cosmetic Surgeon and his team are dedicated to excellence in patient care and are committed to treating each and every patient with respect and privacy.

Dr Patrick Briggs offers high quality, natural-looking plastic and cosmetic surgery results and is experienced in BreastBody and Face Surgery having performed over 4500 Surgeries in private practice. Dr Patrick Briggs is an expert in breast, face and body surgery for men and women.

How can we help?

Dr Briggs’ Patient Coordinators take pleasure in assisting you with any questions when considering a plastic surgery procedure. Please call the Hawthorn East clinic in Melbourne between 8 am – 6 pm on Weekdays.

Phone 1300 264 811Email us or Book a free 15-minute Call with Dr Patrick Briggs’s team.

What Next?

Want more information about your Procedure?

  • For more information about pricing and payment methods, please visit our page on Surgery Payment options.
  • Talk to our Patient Care Team from 8am to 6pm Monday to Friday on 1300 264 811.
Dr Patrick Briggs consultation

What to Bring to Your Consultation

  • If you like, please bring a friend or relative to help discuss the information and your choices.
  • Take a lot of notes and thoroughly examine the documents your surgeon provides.
  • You may need to undress so it’s a good idea to wear simple clothes.

How to Book a Consultation

  • Dr Briggs Consultation fee is $300.
  • A referral from your GP or your specialist is helpful but not essential. However,
  • To claim any Medicare or Health Insurance you will need a referral.
  • Please contact the Patient Care Team at Coco Ruby Plastic Surgery today to book your consultation.

*Disclaimer: Individual results can vary significantly from patient to patient. The information we provide is general.  For further information on what to expect for your preferred procedures, arrange to see one of our Specialist Plastic Surgeons for a full history and surgical consultation.

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