How To Get Diastasis Recti Surgery Covered By Insurance?

Getting diastasis recti surgery insured by insurance is overwhelming because the coverage differs based on the specific insurance policy and the medical need for the procedure. In general, if the diastasis is causing major health problems like extreme back pain, hernias, or stomach problems, insurance will likely determine that the procedure is medically essential and will, therefore, cover it. A thorough documentation of symptoms, findings from a physical exam, and the effect on your daily activities provided by your physician will typically be required.

However, insurance companies might need a conservative approach, such as having corrective exercise therapy tested initially. The procedure may be denied coverage if the process is considered purely cosmetic. It is, therefore, essential to talk with your physician and your insurance provider to learn the conditions for coverage.

What Is The Cost Of Correcting Diastasis Recti Through Surgery?

A diastasis-recti repair could cost between $5,000 and $19,000. The exact price of a diastasis recti repair depends on where it is located, the board-certified plastic surgeon, the length, and the extent of involvement in the plastic procedure.

Diastasis recti is a disorder where the two big muscles that run along the stomach’s front (the abdominal rectus muscles) are separated. It can occur in pregnancy since the expanding uterus stresses these muscles. This can happen even after birth because the forces can’t return to their normal position.

Cost of surgery to correct diastasis recti

The cost of surgery used to treat diastasis recti may differ based on various variables, including charges for the surgeon’s services, the surgery place, and the kind of procedure carried out.

Factors affecting cost

Fees for surgeons These fees constitute the most significant portion of the costs associated with the procedure to treat diastasis recti. The surgery cost will differ based on the surgeon’s experience and location.
The location of the surgery The price of the surgery may also vary depending on the area of the procedure. The procedure in major cities is usually more costly than in rural areas.
The type of procedure that is performed can impact the cost of the surgery. More complex systems will generally cost more than simpler ones.

How Can You Cut Costs On Surgical Procedures?

There are a few ways to reduce the cost of surgery to treat diastasis recti.

Find surgeons you like. Request quotes from several surgeons before settling on one.

Think about having the procedure at an operating center or hospital. The cost of hospitalization is usually higher than in surgery facilities.
Check out the payment plans available: Certain surgeons offer discounts or payment plans for cash-based payments.
Consider using a health savings account (HSA) or a flexible spending account (FSA). If you own an HSA or FSA, you can use the funds in these accounts to cover medical expenses, such as operations.

Can Diastasis Recti Surgery Be Considered Cosmetic?

Many insurance companies view diastasis recti as a “cosmetic” procedure. This is only the case for some insurance companies. Suppose you choose to proceed with surgery for diastasis recti. In that case, waiting a minimum of a year following your child’s birth is recommended so that your body has time to fully recover and all muscles regain their proper position.

Introduction

Diastasis recti is when the two major muscles that run along the stomach’s front (the muscles of the abdominis rectus) split. This may occur in pregnancy since the expanding uterus puts tension on muscles. It could also happen after birth because the forces can’t return to their normal position.

Can diastasis recti surgery be considered IC?

The question of whether diastasis recti surgery is considered cosmetic or not depends on the particular situation. Certain people who suffer from diastasis recti can suffer from severe physical ailments, including back pain, urinary incontinence, and difficulty exercising. In these situations, surgery may be medically required.

For others, diastasis recti might be a cosmetic issue. Surgery may not be required if the space between the muscles is not too large and doesn’t cause any physical discomfort.

The factors that determine if surgery is medically needed

The following variables can decide whether or not surgery is medically required for diastasis recti:

The width of the gap between muscles
The degree of physical symptoms
The patient’s age and general health

The goals of the patient for the surgery

It is based on the factors determining whether a procedure is considered cosmetic.

The following aspects can help decide whether cosmetic surgery is a good option for diastasis recti

The gap between muscles

The satisfaction of the patient with their image
The patient’s goals for the procedure

What Type Of Doctor Is Responsible For The Diastasis Of The Recti?

Is Diastasis Recti a Hernia? Although the abdominal hernia and diastasis recti might appear similar, they differ. Diastasis recti does not represent an intestinal protrusion or abdominal tissues, like hernias; it’s an increase in muscle mass because of the stretch of connective tissue.

Diastasis Recti is a condition where the two big muscles that run along the abdominal front (the muscles of the rectus abdominis) split. It can occur in pregnancy since the expanding uterus exerts tension on muscles. It could also occur following pregnancy since the forces might not be able to return to their normal position.

What can you expect from seeing the doctor for diastasis recti?

When you visit a physician for diastasis recti, they’ll likely conduct a physical exam. They’ll also inquire about your symptoms and medical background.

The doctor can also recommend imaging tests like an ultrasound or MRI. These tests will help assess the distance between the muscles in your rectus abdominis.

Options for treatment of diastasis recti

There are several treatments for diastasis recti:

Non-surgical treatments There are a range of non-surgical therapies that help reduce the distance between your rectus abdominal muscles. The treatments include:
Exercise: Performing exercises that strengthen the core muscles of your body can assist in narrowing the distance between your abdominal muscles.

Therapists in physical therapy can assist you in creating a personalized fitness program that’s right for you.
Corsets: Corsets can help support your abdomen and lessen the strain on your abdominal muscles.

Surgery is possible for patients with a wide gap between the muscles of their rectus abdominis or who have been unable to treat their ailments with non-surgical treatment.

How Do You Get To Sleep After Diastasis Recti Surgery?

Surgeons recommend using a recliner instead of lying flat on your mattress (like you usually do). A recliner (a kind of chair that can fold down the middle) gives you the comfort and security to sleep while maintaining an incline at the center of your body.

Tips for getting comfortable

Here are some suggestions to relax when you sleep after diastasis recti surgery:

Put a cushion under your knees. This will relieve pressure in your stomach and back.

Utilize a buffer between your legs. This will help improve your posture and decrease discomfort.
Put a pillow behind your back. This will aid in keeping you from slipping onto your back.
Wear loose-fitting clothes. This will lower the pressure on your cuts.

FAQ’s

Is diastasis recti surgery typically covered by insurance?

Diastasis recti surgery may be covered by insurance if it is deemed medically necessary. Insurance coverage can vary depending on your specific insurance plan, policy, and the severity of the condition. It is crucial to review your insurance policy or contact your insurance provider to understand the extent of coverage available to you.

How can I determine if my insurance covers diastasis recti surgery?

To determine if your insurance covers diastasis recti surgery, review your insurance policy documents or contact your insurance provider directly. Look for specific information regarding coverage for reconstructive surgeries, abdominal wall repair, or hernia repair procedures. Your insurance provider can provide you with accurate information about the coverage available under your plan.

What documentation do I need to provide to get diastasis recti surgery covered by insurance?

The documentation required to get diastasis recti surgery covered by insurance can vary. Generally, you will need a referral or prescription from a healthcare provider specializing in abdominal wall reconstruction or plastic surgery. Supporting medical documentation, such as physical examination findings, diagnostic imaging results, and evidence of failed conservative treatment, may be required. Consult with your healthcare provider and insurance company to understand their specific requirements.

Are there specific criteria for insurance coverage of diastasis recti surgery?

Insurance companies may have specific criteria for coverage of diastasis recti surgery. Coverage criteria may include the severity of the condition, the presence of related symptoms or functional impairment, failed conservative treatments, and documentation of medical necessity. It is important to consult with your healthcare provider and insurance company to understand the specific coverage criteria.

Can I appeal if my insurance initially denies coverage for diastasis recti surgery?

Yes, if your insurance initially denies coverage for diastasis recti surgery, you have the right to appeal their decision. The appeals process allows you to provide additional documentation or evidence to support the medical necessity of the surgery. Consult with your healthcare provider, gather relevant medical records, and follow the insurance company’s appeal process to increase the chances of coverage approval.

Are there alternative options if insurance does not cover diastasis recti surgery?

If insurance does not cover diastasis recti surgery, there may be alternative options to consider. You can explore financing options, such as payment plans offered by the healthcare provider or obtaining a medical loan. It is important to discuss the cost and payment options with your healthcare provider to make an informed decision.