Will Insurance Cover Removal of Extra Skin?

I am 51 years old and used to weigh 280 lbs. Six years ago, I lost all the weight; now I weigh 100 lbs. i had 2 c-sections, a tubual ligation through another incision and total hysterectomy through another. The incision caused a lot of pain and I have hanging loose skin. It is not terrible but I get yeast infections, sores and have trouble emptying my bladder without pushing on my stomach. My GP has recommended that I see to have the extra skin removed. Is this something that insurance may cover?

Doctor Answers 6

Will insurance cover removal of extra skin?

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Hello! Thank you for your question! I hope that these answers help! A panniculectomy is an excellent method for removing the excess skin and soft tissue of the lower abdomen (abdominal panniculus), often caused by weight loss. It is mainly performed to ameliorate symptoms caused by the abdominal apron such as hygiene issues, excoriations, rashes/infections, back pain, etc. A panniculectomy gives almost immediate relief from these issues as well as has been shown to stimulate additional weight loss as your activity level is increased after removal of the panniculus. An abdominoplasty is more of an aesthetic procedure in that as opposed to simply excising this excess tissue in a wedge to relieve complaints, an abdominoplasty focuses more on abdominal contouring, abdominal wall tightening, re-insetting the belly button, as well as often times the addition of liposuction. 

I would highly recommend continued diet and exercise prior to any consideration for a panniculectomy or body contouring as getting down to your ideal weight prior to the procedure will certainly give you the best results as well as be the safest for you.  Neither one is a weight loss procedure.  Also, a continued healthy and active lifestyle will be needed in order to maintain the benefits that the procedure has given to you. You should consult with a plastic surgeon at anytime to go over options and in order to assist you in deciding which procedure(s) would be right one for you.  Depending on your examination, photo documentation, and discussion of your symptoms, insurance coverage may be possible.  Best wishes for a wonderful result!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Panniculectomy vs Tummy Tuck

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I have recently discussed this on my websites journal section. You may be a candidate for panniculectomy which involves removal of the skin. This is the procedure that insurance may cover. They will not cover an abdominoplasty procedure which is removal of the skin and tightening of the abdominal muscles.

Your plastic surgeon would need to take pictures and submit a predetermination letter on your behalf to basically ask the insurance company if they would cover the panniculectomy procedure.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Will insurance cover removal of tummy extra skin overhang?

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The procedure you are inquiring about is called a PANNICULECTOMY and involves the removal of only the skin overhang. It is NOT an Abdominoplasty (tummy tuck) which is a cosmetic procedure in which not only is any loose tummy skin removed but the abdominal muscles are tightened from the pubis to where the ribs meet in the midline and the belly button is translocated to allow skin removal. The latter operation is NEVER paid for by insurance companies.

The best strategy is look in your insurance benefits book if your policy even covers it. If it does, your insurer SHOULD have a list of plastic surgeon who accept your policy.

Copy that list and review it against their listings at www.Plasticsurgery.org - The American Society of Plastic Surgeons members listing and you will be able to choose which one of them to see.

Good Luck.

Peter A Aldea, MD, FACS

Peter A. Aldea, MD
Memphis Plastic Surgeon

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Panniculectomy and insurance

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Insurance coverage for a panniculectomy may be possible. It depends upon your insurance company and your documentation.  Also, some doctors do not accept insurance and so you many have to pay out of pocket for this procedure.

Steven Wallach, MD
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Insurance coverage for panniculectomy

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With your history, it is possiblethat you might get smoe insurance coverage depending on your insurance plan. They look for things like yeast or bacterial infections, dermatitis, ulcers, etc. These indicate a medical necessity for removal of the hanging skin. Whehter they will pay only for a panniculectomy or a full abdominoplasty is debatable. Evidence of abdominal hernia would strengthen your position.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Insurance coverage of massive weight loss

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This will vary according to your insurance program. It is best for you to select a surgeon first and then ask them to submit a predetermination of benefits letter to your insurance carrier. They will then be more likely to approve your procedure.

Otto Joseph Placik, MD
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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.