Diastasis Recti - Dublin,CA

My understanding is that if you focus primarily on the pain and discomfort you are in and that it is directly related to your Diastsis Recti issue, then insurance will cover it.

But you have to be very convincing that your extreme pain is the result of this problem. I think a surgeon would back you on this claim. Remember, the squeaky wheel gets the oil..so roar loudly. Chronicle your pain and how pain relievers don't work and that they are not the long term fix, etc.

GL~!

Why do you think that the insurance company will consider it cosmetic? Does not sound cosmetic to me. It causes discomfort and you have very little abdominal strength. Those are medical issues.

I suggest that you let the doctor's office contact the insurance company to see if they'll cover surgery. Most doctors' billing people know how to code things so that they are covered.

I know of a man who had this surgery and it was covered. Also a woman.

If it's directly causing pain, I would think the surgeon would have some leeway in urging the insurance company to review its claim denial. I'm sure a 2nd opinion would be required and sometimes the insurance companies have their own doctors. It's worth exploring.

Hernias and loose tissue strength is from a copper deficiency. Look this up online. You should probably try to take a copper/zinc supplement to see if it will repair. I know one person online who said he repaired his hernia with copper. Copper is responsible for collagen (also vit c and A I think as well) but especially copper.

My SIL had a 5 finger split. Not sure how bad yours is, but since you're familiar with this world...you know how bad that is. Her plastic surgeon said he'd never seen a case as bad as hers.
And ins would not cover it, despite his help.
Sorry mama.

I will tell you, I've had a full TT with muscle repair myself. It was the BEST decision I ever made, and worth every single penny we've paid out of pocket.
We used Care Credit to "finance" the surgery, and it's been wonderful.
Not only do I feel a million times better, but I look like a million bucks.
If there's any possibility you can cover it out of pocket, I strongly encourage you to do it even without insurance.
You'll NEVER regret it.

The "surgeon working with the insurance" you mention is your surgeon contacting the insurance company on your behalf and explaining your individual situation. Typically the doctor's office sends in a request for pre- approval of the surgery. If the surgery is denied, they will state the reason. At that point, your doctor would contact the insurance company to explain why your case is "medically necessary".

If your pre-approval is denied, I would contact the insurance company myself and find out what steps I needed to take to get the issue reconsidered- second opinions, etc. Offer to go to a doctor of their choosing. Keep notes on all calls you make and whom you speak to.

Your success is going to depend largely on you and how you've presented yourself so far. Is your motivation to look better or to improve your health? Have you tried everything the doctor has recommended so far? Did you first come to the doctor because of pain or because of your appearance?

Best of luck to you.