Why do so many doctors not work with insurance companies for thigh lift surgery?

I think you would find most insurance companies don't cover thigh lifts. It's best if the patient calls the insurance company themselves to see if this is covered. There are so many different plans, even within the same company.

Thank you for your question about the complexities of insurance coverage for thigh lift surgery and why many doctors may not work with insurance for this procedure.
Insurance Authorization: Thigh lift or thigh reduction surgeries are rarely authorized by insurance companies. This reluctance often extends to procedures following massive weight loss, as these are frequently categorized as cosmetic rather than medically necessary.
Procedure Comparison: It's important to note the distinction between a panniculectomy and a thigh lift. While a panniculectomy, which removes excess skin and fat from the lower abdomen, may sometimes be covered by insurance, thigh lifts generally do not receive the same consideration.

Reimbursement Rates: The compensation offered by insurance companies for thigh lifts is often disproportionately low compared to the time and effort required for both the surgery and postoperative care.
Operational Constraints: Insurance requirements, such as the necessity of performing the surgery in a hospital setting, can present logistical challenges for busy plastic surgeons, making it impractical to align their schedules with hospital availability.
Due to these factors, many plastic surgeons choose not to navigate insurance for thigh lift surgeries, focusing instead on elective, self-pay procedures. I hope this explanation clarifies the reasons behind the general reluctance of plastic surgeons to work with insurance companies for thigh lift procedures.
Wishing you all the best in your surgical journey.

Sincerely,
Dr. Katzen

Thigh lifts are typically considered cosmetic and not covered by most insurance companies. Often times if a procedure is covered by insurance the coverage amount is very low. In these cases the surgeon may feel effort is better placed elsewhere. We offer to help our patients connect with companies that specialize in financing for procedures. These companies can assist our patients so that they can get the surgery or treatment they desire and the highest quality of care.

Insurance reimbursement is typically very low in comparison to what most plastic surgeons charge for cosmetic surgery.
Once a provider except medical insurance, part of the agreement is that the provider cannot call build a patient more than what the insurance contracted amount is.
Insurance reimbursement is usually around 10% or less of what most plastic surgeons charge for cosmetic surgery.
A procedure that might generate $12,000 if insurance is not involved, may pay $900 from insurance reimbursement.
For this reason, many plastic surgeons simply don’t want to engage with taking care of insurance based patients.
There are plenty of plastic surgeons, but do it except insurance, but insurance companies under Tori is Lee stingy when it comes to authorizing procedures that are generally considered cosmetic surgery. I personally have never heard of this company, paying for a thigh lift. Generally speaking to get insurance company to cover the procedure there Hass to be a correlating diagnosis ICD 10 code that is a condition that justifies the procedure.
For a panniculectomy that is typically going to be a skin rash.
Lots of women have skin that rubs on their inner thighs whether they were lost weight or not so I don’t think treatment for skin irritation on the thighs is ever going to be covered by insurance company.
Its your medical insurance, so you can look up to see which procedures are covered under what terms.
Contact your insurance provider and ask if they cover they left surgery and if so, what are the underlying diagnostic criteria for having the procedure covered.
When I requested insurance coverage for a panniculectomy, I would say most of the time the claims have been denied. Whenever I’ve had cases approved it almost always required an appeal and manual review.
To do this typically requires back-and-forth communication and sending in a variety of justifying information. A simple process of obtaining insurance information for a major surgical procedure can be quite labor-intensive.
There is no reimbursement for requesting insurance authorization, even if it takes hours of work.
Personally, I view a thigh lift as a cosmetic surgical procedure and don’t think it should be covered by medical insurance.
Medical insurance is a resource available to those in need, and the decision to limit expenses keeps insurance premiums under control.
Look for plastic surgeons who are involved with breast cancer reconstruction. These are often surgeons who do a lot of insurance based surgery.
Alternatively, consider academic medical centers where insurance is usually accepted as well.
You can also look for plastic surgery providers assigned to your medical insurance program.
Best,
Mats Hagstrom, MD