Diastasis recti is a condition that affects many people, especially women who have given birth. It is a separation of the rectus abdominis muscle, which can cause a bulge in the midsection and contribute to other issues such as back pain and poor posture. In severe cases, diastasis recti surgery may be necessary to repair the muscle and restore the body’s natural shape. However, the cost of the surgery can be a major barrier for many people. In this article, we will explore how to get diastasis recti surgery covered by insurance.
What is Diastasis Recti Surgery?
Diastasis recti surgery is a procedure that repairs the separation of the rectus abdominis muscle. The surgery involves making an incision in the abdomen and tightening the muscles. This procedure is typically done under general anesthesia and may require a hospital stay of a few days.
Does Insurance Cover Diastasis Recti Surgery?
Whether or not diastasis recti surgery is covered by insurance varies depending on the individual’s insurance policy and the severity of the condition. In general, insurance companies will only cover the surgery if it is deemed medically necessary. This means that there must be evidence that the condition is causing significant physical or functional impairment that cannot be corrected through other means such as physical therapy or exercise.
Steps How to Get Diastasis Recti Surgery Covered by Insurance
If you believe that diastasis recti surgery is medically necessary for your condition, there are steps you can take to increase the likelihood of getting it covered by insurance:
- 1. Consult with a medical professional: The first step is to consult with a medical professional who can evaluate your condition and determine if surgery is necessary. They can also provide documentation to support the medical necessity of the surgery.
- 2. Check with your insurance company: It is important to check with your insurance company to understand what is covered under your policy and what documentation is required to support the claim.
- 3. Get pre-authorization: Pre-authorization is a process in which the insurance company approves the surgery in advance. This can help ensure that the surgery will be covered and prevent unexpected costs.
- 4. Appeal the decision: If your claim is denied, you have the right to appeal the decision. This can involve providing additional documentation or working with your healthcare provider to provide additional information to support the claim.
Alternative Options for Covering Diastasis Recti Surgery
If insurance does not cover diastasis recti surgery, there are alternative options for covering the cost of the procedure:
- 1. Payment plans: Many healthcare providers offer payment plans that allow patients to spread out the cost of the surgery over a period of time.
- 2. Medical financing: There are medical financing companies that offer loans specifically for medical procedures. These loans typically have lower interest rates than credit cards and can be paid back over time.
- 3. Crowdfunding: Crowdfunding platforms such as GoFundMe can be used to raise money for medical expenses.
FAQ How to Get Diastasis Recti Surgery Covered by Insurance
Q: What is diastasis recti surgery?
A: Diastasis recti surgery is a procedure that repairs the separation of the rectus abdominis muscle, typically done under general anesthesia and may require a hospital stay of a few days.
Q: Does insurance cover diastasis recti surgery?
A: Whether or not diastasis recti surgery is covered by insurance varies depending on the individual’s insurance policy and the severity of the condition. Insurance companies will only cover the surgery if it is deemed medically necessary.
Q: How can I increase the likelihood of getting diastasis recti surgery covered by insurance?
A: The steps to increase the likelihood of getting diastasis recti surgery covered by insurance include consulting with a medical professional, checking with your insurance company, getting pre-authorization, and appealing the decision if necessary.
Q: What are the alternative options for covering diastasis recti surgery?
A: Alternative options for covering the cost of diastasis recti surgery include payment plans, medical financing, and crowdfunding platforms.
Q: What if my insurance claim for diastasis recti surgery is denied?
A: If your insurance claim for diastasis recti surgery is denied, you have the right to appeal the decision by providing additional documentation or working with your healthcare provider to provide additional information to support the claim.
Conclusion
Diastasis recti surgery can be life-changing for individuals who are struggling with the condition. However, the cost of the surgery can be a significant barrier for many people. By understanding the steps to get diastasis recti surgery covered by insurance and exploring alternative options for covering the cost, individuals can make informed decisions about their healthcare and get the treatment they need.
