Ask a doctor

Is Medically Necessary Liposuction.. Ever Covered by Insurance?

I am 175, 5'6" I need lipo for my abdomen. I am not "slightly" apple shaped; I have size 6 legs and a size 16 belly. I feel it is medically necessary:

1) I have severe GERD & the weight around my midsection presses on my stomach. The GERD is always worse when I am sitting up & is often unbearable at work when I have to sit for long periods.

2) Two years ago I had vaginal reconstruction & the pressure is destroying the fix.

3) Losing weight will not correct the fat distribution. Ever covered?

Doctor Answers (25)

Liposuction is NEVER covered by insurances!

+3

Liposuction has never been or ever will be covered by health insurances.  Some docs did it yrs ago under the disquise  of a tummy tuck or laparoscopy surgery but it was illegal. 


Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 27 reviews

Liposuction not Covered by Insurance

+2

Liposuction is not a means of weight loss and is not covered by insurance companies as it is deemed a cosmetic procedure. From El Paso.

Frank Agullo, MD
El Paso Plastic Surgeon
5.0 out of 5 stars 31 reviews

Liposuction is not medically necessary

+2

Liposuction is always done for the reasons you describe: Localized fat ccumulation that for whatever reason you can't get rid of. In your case you may have more than the usual difficulties trying to lose the fat, but your health insurance will categorically deny it regardless. From your description it sounds more likely that you would need a tummy tuck, but the same restriction applies re insurance.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 28 reviews

You might also like...

Medically Necessary Liposuction?

+2

Liposuction is never considered medically necessary.  If you decide to have liposuction, your insurance will not cover it.  If you are looking for weight loss surgery, then you may want to ask your primary care provider for a referral to a bariatric surgery clinic.  The bariatric surgeries are sometimes covered by insurance.  However, these are not cosmetic surgeries.

Good luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 57 reviews

? Medically Necessary Liposuction

+2

Liposuction is a type of body-contouring surgery.  It is best done in patients close to their ideal body weight who cannot achieve a reasonable shape despite appropriate diet and exercise.  It is not a procedure done for weight loss.  Even if an insurance company covered the surgery,  it is very questionable if you would have any significant relief  from your symptoms. 

Stephen Delia, MD
Boston Plastic Surgeon
5.0 out of 5 stars 10 reviews

Liposuction through insurance is rare

+2

Medical necessity for liposuction is very rare unless you have a very specialized policy. You can contact your claims administrator for help if you need an explanation of your insurance benefits. It does sound like weight loss is medically necessary and it is probably time to head to the gym.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 31 reviews

No- Liposuction is cosmetic surgery for what you describe.

+2

An insurance company pays for medically necessary procedures that improve the health of patients that are clinically proven. Reducing the weight of the abdominal wall has not been shown clinically to improve the health of a patient by  reducing the symptoms of Gerd nor   pressure on the pelvic area to my knowledge.

Weight loss may improve these symptoms.

Walter D. Gracia, MD
Arlington Plastic Surgeon
4.5 out of 5 stars 3 reviews

Liposuction and Health Insurance

+2

Health Insurance companies today are a lot different and are very stringent on what they will and won't cover. I would suggest having a consultation and then submitting to your insurance company to see if they will approve you. Another thing to consider is what type of abdominal fat do you have, is it subcutaneous (under the skin) or intra-abdominal? Liposuction only works for subcutaneous fat. Intra-abdominal fat can only be addressed with diet and exercise

Bernard Shuster, MD
Hollywood Plastic Surgeon
5.0 out of 5 stars 15 reviews

Liposuction covered by insurance

+1
You will have to consult your insurance provider to find out if your liposuction is covered. However, in general, the answer would be no unless it would resolve a physical impairment directly caused by excess subcutaneous fat in the area you want to target, and liposuction is proven to be the most suitable treatment for you. In your case, a healthy diet and exercise may be recommended instead.

However, you may be able to still cover your surgery with financing. Payments can be as little as a couple hundred dollars a month.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 74 reviews

Non-cosmetic liposuction

+1
There is no such thing as non-cosmetic liposuction. insurance companies consider any and all liposuction cosmetic and not medically necessary. You should see a gastroenterologist and pursue medical management of the GERD.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 13 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.