Does Insurance or Medicare Cover Belt Lipectomy Surgery?

A belt lipectomy is a type of surgery that removes the excess fat and skin from around your waist. Since the extra tissue tends to exist along your beltline, the surgery has been dubbed a belt lipectomy. It’s all known as a panniculectomy if you want to be more technical. The surgery is recommended following extreme weight loss and is a commonly requested procedure after bariatric surgery.

What is a Belt Lipectomy?

When people gain a significant amount of weight, the skin stretches to accommodate the added volume. When you subsequently lose weight, your skin doesn’t always have what it needs to bounce back. Excess and hanging skin can result.

In addition to added tissue along your beltline, you may also have extra skin folds along your arms, under your chin, and along with parts of your thighs. A belt lipectomy combined with body contouring procedures such as the arm lift or thigh lift can improve how you look. They can also improve your self-esteem.

The question is: Will a belt lipectomy be covered by health insurance? This is a complex issue and one that requires a bit of explanation.

When Does Insurance Cover a Belt Lipectomy?

When losing fifty to a hundred pounds of excess weight has left you with hanging skin, there are several symptoms you may experience. You may have a loss of mobility. Exercise may be difficult to manage, for example. Every time you try to do jumping jacks or jog, your saggy skin stubbornly gets in the way. This is one example of a symptom that health insurance may pay attention to.

Another is the condition that can affect your skin as a byproduct of having saggy and excess skin. Rashes and painfully irritated skin can result, which can become infected. If these rashes send you to the doctor, health insurance may approve your belt lipectomy coverage.

Indications for Successful Belt Lipectomy Coverage

Belt Lipectomy Coverage

The above examples have one thing in common. They position the surgery as being medically necessary for the improvement of your health. If you can’t exercise or face infections on account of your excess skin, those things could harm your health. Health insurance can then cover some or all your costs associated with belt lipectomy surgery, giving you less discomfort (physical or emotional) and a better quality of life.

Common indications that health insurance will pay for your panniculectomy include the following:

  • The Skin Hangs Low: The hanging skin referred to medically as a panniculus, can hang to either side of your pubic bone, which is usually when problems like irritated skin and rashes begin to occur.
  • Doctor Visits for Rashes: If the panniculus is the primary cause of skin conditions that send you to the doctor for treatment, the health insurance companies are more likely to cover your belt lipectomy procedure.
  • Loss of Function: If you can’t drive, ride a bike, or touch your toes because of excess skin, check your insurance policy. You may be covered for a panniculectomy, which can restore or enhance your functional impairment.

Requirements for Belt Lipectomy Insurance Coverage

All insurance providers are unique, and every policy is different. For that reason, check your policy for evidence that belt lipectomies are covered. You should be sure and read the fine print. Many policies, for instance, require that you maintain a stable weight for at least six months following your extreme weight loss.

For weight loss surgery patients, you may have to wait for between twelve and eighteen months following surgery to pursue care for a hanging and life-limiting panniculus.

When is a Belt Lipectomy Not Covered by Insurance?

Health Insurance

A panniculectomy is not covered when the surgery is purely aesthetic in nature. In other words, insurance providers usually will not pay for reconstructive or cosmetic surgeries. The following checklist can help you determine if your problem is reconstructive or medically necessary.

Do you have neck or back pain? If the hanging skin pulls on your neck and back muscles, causing dull to severe pain, you have a good case for insurance coverage. If not, you may have to pay out of pocket for a belt lipectomy procedure.

Are you having the procedure performed after pregnancy? Insurance providers may pay for your surgery after childbirth if the hanging skin causes you discomfort or pain. The insurance company is not likely to pay if your goal is to transform your body as part of a mommy makeover procedure.

Does This Information Count for Medicare and Medicaid as well?

Yes. Medicaid, like insurance, tends to only pay for medical procedures where there is a medical need. You would need to demonstrate that the excess skin holds you back, causes discomfort or pain, and otherwise inhibits your life. Some Medicaid and Medicare requirements want you to demonstrate that you have maintained your weight for at least six months or longer and want a letter from your doctor stating that the belt lipectomy is necessary for improving your quality of life.

What Other Options Are Available to Pay for Hanging Skin After Weight Loss?

When the hanging skin following extreme weight loss causes you major distress, but insurance will not cover the procedure, there are options available. Medical financing is one such option. Companies like CareCredit and Prosper Healthcare Lending offer instant decisions and large amounts for the payment of common surgeries like belt lipectomy or panniculectomy.

Get Help Navigating Insurance at Moein Surgical Arts

At Moein Surgical Arts, we specialize in helping people achieve their aesthetic ideals. In addition to being a body contouring surgeon, Dr. Babak Moein is dually trained as a bariatric surgeon. That means the doctor can help you lose weight through weight loss surgery. He will also help you achieve your body-shape goals after the excess weight has come off.

Dr. Moein would like to meet with you if you have a BMI of 40 and above (or 35 with one or more comorbidities like high blood pressure or type 2 diabetes). His caring and compassionate staff can help you schedule a consultation. They will navigate with the insurance companies to see if your procedure is covered.

To learn more about weight loss surgery (bariatric surgery) and the belt lipectomy after the weight has come off (in addition to insurance coverage for such procedures), schedule a consultation with Dr. Moein by calling (310)694-4486.

Dr. Babak Moeinolmolki

CALL US : +1(310)455-8020

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