Thank you for your question regarding what you do with your lower abdomen and whether you can have a panniculectomy without a tummy tuck. Not all medical procedures are covered by insurance. Some insurance companies cover the panniculectomy, whereas other insurance companies do not. Fortunately, your insurance company, namely Medicare and Tricare has approved your panniculectomy. If you are medically healthy, you can undergo just a panniculectomy. You do not necessarily need to have a tummy tuck. Not all patients that undergo a panniculectomy require a tummy tuck. I suggest you find a plastic surgeon who will accept Medicare reimbursement for a panniculectomy. I believe the problem is neither you, nor your insurance. I believe your problem is that you cannot find a plastic surgeon willing to perform your panniculectomy under Medicare or Tricare reimbursement rates. I suggest you contact a plastic surgeon in your area that is willing to accept Medicare or Tricare reimbursement for a panniculectomy. Perhaps, consider going to a university hospital where there are residents in training (like Baylor or University of Texas) or a local military base for Tricare coverage. Thank you for your question regarding panniculectomy coverage under Medicare versus paying more for a tummy tuck. I specialize in reconstructive plastic surgery after weight loss. If you have any more questions regarding the panniculectomy, tummy tuck, extended tummy tuck, high lateral tension tummy tuck, abdominoplasty, lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please contact my office. Since the panniculectomy or extended tummy tuck are big procedures, please seek an experienced, board certified plastic surgeon with significant experience performing the panniculectomy or extended tummy tuck. Do your research. Make sure they have performed at least 100 panniculectomies or extended tummy tuck 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 extended tummy tuck surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, 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.)