Is It Difficult to Get Insurance to Cover a Panniculectomy?

Question

Of course insurance will only cover it if deemed medically necessary but what does that mean? I've read some policies require you to actually have cellulitis that doesn't respond to antibiotics and is causing tissue damage. That seems crazy that rashes, rubbing, pain or restricted mobility wouldn't be enough! So is this just what they say to scare ppl off or is it really, really hard to get ins to cover a panni?

Larry S. Nichter, MD, MS, FACS · Answer

Yes it is very difficult for insurance companies to cover panniculectomy procedures. A panniculectomy simply means removing the apron of skin and fat that hangs over the belt line without undermining. Occasionally insurance will cover this procedure if there are medical indications such as recurrent infection or functional problems. It is part of the tummy tuck procedure which in addition usually involves extensive undermining as part of  body contouring, correcting separated and lax abdominal muscles (e.g. diastasis recti correction) and often removing some fat by liposuction of the upper abdomen, flanks and hips if needed. Only the panniculectomy portion can sometimes be covered by insurance. In essence, A Tummy Tuck (Abdominoplasty) is a plastic surgery procedure designed to flatten the abdomen by removing excess skin and fat, and to tighten the abdominal wall.

Josef Hadeed, MD, FACS · Answer

Different insurance companies have different criteria that determine whether they will approve a panniculectomy.  Generally speaking, though, if there are frequent or recurring rashes requiring antibiotics or topical creams, or skin breakdown, this would have to be documented by a dermatologist prior to approval by an insurance company.  Best wishes.

Is It Difficult to Get Insurance to Cover a Panniculectomy?

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Is It Difficult to Get Insurance to Cover a Panniculectomy?

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Everything you need to know about Panniculectomy

Our mission is to create a world where every investment in modern beauty is Worth It.