Are there medical reasons (medical necessity) to have a brachioplasty? (photos)

Yes, there are medical reasons to necessitate an arm reduction or brachioplasty. Over the past 15 years I have had a significant number of patients authorized by their insurance companies for arm reduction or brachioplasty due to redundant, excess upper arm skin and fat. Insurance approval depends on your anatomy, history, medical plan, strength of your plastic surgeon’s letter requesting for arm lift surgery, and the eventual approval by hopefully, a medical doctor in your insurance plan. Please note, however, there are no rules and every insurance plan has their own individual rules. To make matters even more confusing, every state also has independent rules requiring medical coverage for certain conditions. I have often had arm reductions or brachioplasties covered by insurance if the patient can document rashes and difficulty keeping the axillary region clean. In addition, I have been able to get approval from insurance companies for brachioplasty if my patient can prove that their arms interfere with activities of daily living. I had one patient get authorized for surgery because she was a cook and kept burning her arms on the stove. I had another patient who was required to wear uniform at work. Due to the size of her arms, she could not fit into the required uniform. Because of this situation, her work insurance had to authorize her arm reduction surgery.Based on your pictures, I would hope any and all medical insurance plans would cover your arm lift or brachioplasty.I hope this answers your question regarding insurance coverage for arm lifts, arm reductions, and brachioplasties. Good luck! If you have any more questions regarding your arm lift or insurance, please contact my office. Sincerely, Dr. Katzen.

Thanks for your question and the accompanying photos.  Without question you would benefit from a brachioplasty.  Unfortunately, even in the context of pain and frequent documented infections, it has become increasingly difficult to have insurance cover body contouring procedures.  It really varies from insurance company to insurance company but overall the trend is the same.  The best you can do is have a plastic surgeon and your primary provider write letters including ICD-9 (diagnosis) and CPT (planned procedure) codes with photographs to your insurance company and hope for the best.  I am sorry I couldn't be more helpful!   Good luck!

Thank you for your question. In my opinion you would benefit from a brachioplasty. One would think from your complaints including skin rash and muscalsketial pain this would be covered by insurance. The reality is every insurance companies have different policies. I would recommend that your plastic surgeon summit a letter of medical necessity to your insurance carrier and see what they say. I hope you find this information helpful.