Will insurance pay for skin removal after weight loss surgery knowing I have hs?

In many cases, insurance can cover skin removal (panniculectomy or sometimes abdominoplasty) after significant weight loss, but it depends on medical necessity—not just the presence of excess skin.

Having hidradenitis suppurativa can actually strengthen the case for coverage, especially if the excess skin is contributing to:

Recurrent inflammation or painful flares
Chronic infections or drainage
Difficulty maintaining hygiene
Functional issues like skin rubbing, irritation, or restricted movement

Insurance companies usually look for documentation that conservative treatments have not been enough—things like topical or oral medications, hygiene measures, and dermatology follow-ups.

The most important factor is how well your symptoms are documented. If HS flares are occurring in areas where excess skin folds are trapping moisture and friction, that can support the procedure being considered medically necessary rather than cosmetic.

However, approval is never automatic. Each insurance plan has its own criteria, and they often require:

Stable weight for a period of time
Medical documentation of recurrent infections or skin breakdown
Photographs and clinical notes from your physician or dermatologist
Sometimes a trial of medical management first

So the short answer is yes—it may be covered, and HS can be a very relevant diagnosis in supporting approval, but it depends on the severity, documentation, and your insurance policy.

As a provider I have never had success getting anyone approved for skin removal surgery based on symptoms alone. Typically, the skin must hang a certain amount (for example, for abdominal panniculectomy it must hang below the pubic bone) for insurance to cover the procedure. Even then, insurance will cover the basic skin removal but any additional cosmetic contouring would be at the cost of the patient.

Hi Magical502018,
While insurance will typically pay for excision of hidradenitis as this is a legitimate medical condition, it will not necessarily pay for excision of excess skin. If the excess skin is directly leading to a medical condition, it may be covered, but this can be inconsistent depending on patient factors and individual insurance companies. You must also be aware that if approved, insurance will only pay for skin removal and not cosmetic procedures such as transposition of your umbilicus or repair of rectus diastasis.
Hope this helps!

Insurance may pay for your skin removal as you have a medical condition that is exacerbated by the excess tissue. Please keep in mind that coverage, if provided, would include skin removal only and not cosmetic procedures such as a tummy tuck which include muscle tightening. Check with your insurance carrier for policy specifics.

Insurance will usually pay for excision of Hydradenitis because it is abnormal, infected skin. They will not typically pay for excess skin removal after weight loss unless it is causing a medical problem.