Health insurance application for abdominoplasty
Specialist report
A specialist report for a health insurance application for abdominoplasty (tummy tuck) serves to demonstrate the medical necessity of the surgery. The health insurance company will only cover the costs if the procedure is not solely for aesthetic purposes, but if there are proven health problems.
Content of the specialist report
The report is usually prepared by a specialist in Plastic and Aesthetic Surgery, Dermatology, or General Surgery, and includes the following key points:
Patient data
- Name, date of birth, insurance number
- Height, weight, and BMI calculation
- Description of the abdominal wall (e.g., excess skin, skin folds)
Medical indication (justification for the surgery)
- Skin folds and tissue excess: After significant weight loss, pregnancies, or age-related changes.
- Chronic skin inflammation (intertrigo): Due to persistent friction and moisture in the abdominal fold.
- Hernias (ruptures): If an abdominal wall hernia is present, this may be another medical reason.
- Back pain and postural damage: If the excess skin leads to poor posture and conservative treatments do not provide relief.
- Psychological stress: In severe cases, psychological distress may also play a role (e.g., depression or social isolation due to excess skin).
Previous treatments and their effects
- Conservative measures such as exercise, physiotherapy, or special creams for skin irritations.
- If weight reduction was necessary, a stable weight pattern should be proven (often health insurance companies require a stable weight for at least six months).
- Documentation that other treatment methods have not provided sufficient improvement.
Description of the planned surgery
- Planned amount of skin and fat tissue removal.
- Surgical technique: A Fleur-de-Lis technique or horizontal tightening is often described.
- If a tummy tuck with muscle tightening is necessary, this should be justified.