Thank you for your question regarding how to get your panniculectomy approved. Usually, for your insurance company to cover and pay for a panniculectomy, you need to meet the following criteria: 1) your abdominal pannus must hang below the level of pubis or pelvic bone, 2) if you lost more than 100+ lbs with diet and exercise, you must be at a stable weight for six months. Suppose you lost more than 100+ lbs with weight loss surgery. In that case, your weight must be stable for 18 months 3) you must have a documented history (in the doctor’s office) of recurrent rashes or non-healing ulcers that are not responding to an antibiotic, antifungal, or steroid creams, and 4) you must have documented difficulty with ambulation or interference with activities of daily living. A panniculectomy solely performed to correct low-back pain is considered NOT medically necessary and usually not covered. I hope this helps answer your question regarding panniculectomy approval. I specialize in reconstructive plastic surgery after weight loss. If you have any more questions regarding the panniculectomy, extended lower body lift, lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please contact my office. Since the panniculectomy or lower body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the panniculectomy or lower body lift. Do your research. Make sure they have performed at least 100 panniculectomies or circumferential lower body lift surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced, panniculectomy or lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)