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Hernia surgery is a regular medical operation that many people have to fix weak or torn muscles in the abdomen. Whether you have an inguinal hernia, umbilical hernia, or hiatal hernia, surgery is usually the best option. The good news is that most health insurance plans cover hernia surgery, but knowing the specifics of your coverage can help you avoid unexpected costs. Board-certified plastic surgeon Dr. David Azouz is in-network with Cigna and can help his patients navigate the insurance process for hernia treatment. This article covers everything you need to know about hernia surgery and insurance, including coverage, prices, and how to optimize your benefits.

types of abdominal hernias

Types of Hernias

Hernias form when an organ or tissue pushes through a weak point in the surrounding muscle or connective tissue. Hernias can be classified into numerous categories, which include:

  • An umbilical hernia is a condition in which a portion of the intestine protrudes through the abdominal muscles at the belly button.
  • Epigastric hernia arises when fatty tissue or a segment of the intestine protrudes through the abdominal wall between the belly button and the lower section of the ribcage.
  • Abdominal wall reconstruction is a surgical treatment that restores the integrity and function of the abdominal muscles. It is frequently performed to treat difficult or recurring hernias.
  • Incisional Hernia: A hernia that develops at the site of a previous surgical incision due to weaker abdominal muscles.
  • Hernia with diastasis is the combination of a hernia and diastasis recti, a condition in which the abdominal muscles separate, weakening the core
  • Hernia repair with panniculectomy combines hernia repair with the removal of extra skin and fat from the lower abdomen, thereby improving function and reducing strain on the repaired area.

Does insurance cover hernia surgery?

Yes, most health insurance policies cover hernia surgery because it is deemed medically necessary. However, coverage may vary depending on the following factors:

  • Type of insurance plan: Private insurance, employer-sponsored health plans, and other insurance kinds all have distinct coverage policies.
  • Deductibles and copayments: Your out-of-pocket expenses are determined by your deductible, coinsurance, and copayment amounts.
  • Preauthorization Requirements: Some insurance companies need preapproval for surgery.
  • In-Network versus Out-of-Network Providers: Selecting an in-network surgeon will greatly minimize costs. David Azouz is in-network with Cigna Insurance.

How Much Does Hernia Surgery Cost With Insurance?

The cost of hernia surgery with insurance varies depending on the policy and medical provider. Open hernia repair is the most common operation, and it is usually covered by insurance. However, additional fees may still apply. Hospital prices vary depending on whether the surgery is performed as an outpatient or an inpatient treatment. Anesthesia and postoperative care may also be costly, with copays required for some procedures.

Steps to Ensure Maximum Insurance Coverage.

To save money and assure correct coverage, evaluate your health insurance policy to see what is covered, including deductibles and out-of-pocket maximums. Choosing an in-network surgeon and hospital can result in significant cost savings. Some insurers need preauthorization prior to surgery, so you should contact your provider ahead of time. In addition, make sure your plan covers post-surgery fees including follow-up appointments, prescriptions, and postoperative care.

Combining Hernia Surgery and Tummy Tuck

hernia surgery after pregnancyMany patients choose to combine hernia surgery with a tummy tuck (abdominoplasty) for medical and cosmetic reasons. A tummy tuck tightens abdominal muscles and eliminates extra skin, improving the overall appearance of the abdomen while treating the hernia. This combined surgery is very effective for patients with significant weight loss or those who experienced muscle separation during pregnancy. Dr. Azouz can evaluate your condition and discuss whether combining these procedures is a good fit for you.

Hernia Surgery with Dr. Azouz.

Dr. Azouz is a board-certified plastic surgeon who has considerable experience doing hernia repair procedures. Patients seeking expert care can rely on Dr. Azouz for tailored care and outstanding results. Dr. Azouz works with a variety of insurance companies and provides advice on how to maximize coverage for hernia surgery. If you’re thinking about having hernia surgery, arrange a consultation with Dr. Azouz to go over your options and get the best medical treatment possible.

Schedule a Consultation with Dr. Azouz

Hernia surgery is an important procedure that is typically covered by insurance, but understanding your policy is essential for avoiding excessive costs. By choosing an in-network provider, obtaining preauthorization, and reading your plan’s coverage specifics, you can reduce out-of-pocket expenses and have a smooth surgical experience. If you’re thinking about having hernia surgery, contact us online or call us at (972) 702-8888 to learn more about getting hernia surgery covered with insurance. Dr. Azouz offers in-person and virtual consultations for patients who are considering traveling to Dallas for surgery.

Posted on behalf of Azouz Plastic and Cosmetic Surgery

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