Will insurance pay for arm lift, if it is so bad I can use my arms?

Arm lift, or Brachioplasty is generally considered a cosmetic surgery and will not be covered by insurance. 

Thank you for your question regarding insurance coverage of arm reduction / arm lifts / brachioplasties. Yes, insurance companies do cover arm reduction / arm lifts / brachioplasties. Insurance coverage for your arm reduction surgery is based on the your physical examination, classification of arm type, your insurance plan, strength of your plastic surgeon's letter requesting surgery, your documentation of arm rashes, documentation of difficulty performing activities of daily life due to your large arms, and the approval of the medical director within your insurance plan. Unfortunately, as you can see, there are many variables. There is no one set of criteria which qualifies or guarantees insurance coverage for an arm lift or arm reduction surgery. Typically, the larger your arms, the more likely your medical insurance is able to approve the arm lift / arm reduction / brachioplasty procedure. You will need to document arm rashes. I would suggest photographing your arms rashes, documenting trips to your doctor for evaluation of these arms rashes, and copying of receipts of medications purchased for the treatment of these arm rashes. In addition, you will need to describe, in writing, your difficulties with activities of daily life, due to your large arms.There are significant variances between insurance companies and even differences in plans within the same insurance company. Insurance plans can also vary from state to state. Most insurance companies require you to be under a certain BMI.In summary, I would suggest seeking an experienced plastic surgeon who is willing to work with you in trying to obtain insurance coverage. I would gather documentation of arm rashes. In addition, before consulting with your chosen plastic surgeon, I would create a list of things that are difficult for you to perform. When you meet with your plastic surgeon, please request that your plastic surgeon submit to your insurance company for prior authorization for arm reduction or brachioplasty. If your plastic surgeon feels it is so indicated, he or she will submit to your insurance company. Then, unfortunately, in the end, it is up to your insurance company to decide whether they will cover your arm lift / arm reduction / brachioplasty procedure or not.I hope this answers your question regarding insurance coverage for arm lifts, arm reductions, or brachioplasties. Good luck! I hope your arm reduction surgery gets authorized by your insurance. If you have any more questions regarding insurance coverage for your arm lift, please contact my office. Sincerely, Dr. Katzen.

Subjective descriptions of "how bad" a problem is usually causes insurance providers to develop criteria that are objective and must be documented in the medical record to obtain coverage. It is doubtful that you will actually meet these criteria, but that will be for your chosen plastic surgeon and your existing insurance provider to work through.Don't get your hopes up, however. I have been an insurance reviewer for Blue Cross/ Blue Shield for years, as well as one for Medicare, and cannot recall one case of brachioplasty that was approvable/approved.Start with consultations with one or more ABPS-certified plastic surgeons, but prepare to cover the cost for this surgery yourself. Don't be swayed by surgeons who tell you they can "get coverage for you," as this is often a claim designed to get you in their office, only to be told later that insurance won't cover it, which they know all along. Best wishes! Dr. Tholen

Its always a challenge getting insiarcne companies to cover procedures that might be construed as cosmetic.There needs to be a documented medical reason such as rash, infection or pain that only surgery can cure.The best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.best of luck!Dr Schwartz

Hello, and thank you for your question. As a general rule in our area brachioplasty is not covered by insurance. I would recommend that you seek out a qualified board certified plastic surgeon in your area to discuss with an in person in consultation

Thank you for your question.  This is primarily a cosmetic surgery , not a medically necessary surgery. 

In most cases the answer is NO.  Your insurance will only cover medically necessary procedures. 

In general, insurance companies do not cover brachioplasty surgery.  For them to consider covering a surgery there needs to a functional problem (they are not concerned about appearance or aesthetics).  In 15 years of performing brachioplasty surgery, the only patient that ever had their surgery covered was a short order cook who had burns on the back of her arms from the skin coming in contact with the grill.  I would recommend see a board certified plastic surgeon that focuses on post-bariatric procedures and schedule a consult.  They can submit your case to the insurance company (this is called a pre-determination) and see if it would be covered. Medicare will not allow a pre-determination, but most other insurances will.Good luck.

My colleagues have provided some very good answers -- it is often difficult to get insurance companies to cover these procedures, unless a functional problem can be clearly proven and demonstrated, and corroborated by photos as well as care providers other than your surgeon (for example, physical therapists and primary care physicians). My one additional suggestion is to simply call your insurance provider and ask them for their criteria for covering the specific procedure (in this case, brachioplasty). They actually typically will have documents spelling out the criteria that they are looking for. If after reading the criteria, you think you satisfy them, then providing the document to your surgeon may be helpful to guide their office consultation and notes. That said, ultimately your surgeon would have to feel comfortable that they are treating a true functional problem, and that he or she can address that problem adequately with surgery. 

In general, I have not had a great deal of success with having insurance cover brachioplasties. There is a very rare case where someone who has lost a lot of weight has rashes/infections in their under arm areas from excess skin, so it's always worth having a consultation with a plastic surgeon and seeing if they think your problem is severe enough to ask for insurance coverage. I always tell my patients to be optimistic but not too hopeful about insurance covering their surgery.