Will a plastic surgeon accept Medicare for my surgery? (Photo)

Question

I have full coverage from Medicare for my tummy tuck because my doctor has decided that it is medically necessary as a result of severe skin complications, emergency room visits, antibiotics, topical creams, and constant issues. I'm currently losing weight, and as the weight comes off the skin causes more problems. Please help!!!

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question. Based on your description, there is a chance that Medicare may cover a panniculectomy, but it is unlikely that Medicare will cover a full tummy tuck (abdominoplasty) in its entirety. It’s important to understand the difference between the two procedures and what insurance typically considers "medically necessary."

A panniculectomy is a functional procedure that removes the excess skin and fat that hangs over the lower abdomen, also called the pannus or "apron." This overhanging skin can cause rashes, infections, ulcers, mobility issues, and difficulty with hygiene, which is why some insurance companies, including Medicare, may cover it—especially if you have documented medical issues like ER visits, antibiotics, and topical treatments.

A tummy tuck (abdominoplasty), on the other hand, is a more comprehensive cosmetic procedure that removes excess skin and fat, tightens the abdominal muscles (if necessary), and repositions the belly button for an improved contour. Medicare typically does not consider this medically necessary, so it is very unlikely to be covered.

If you are currently losing weight, having a panniculectomy may be beneficial because it will make working out and losing additional weight easier by removing the heavy, hanging skin that may be limiting your movement. Some patients also find that once they can exercise more comfortably, they continue to lose more weight, which can lead to even better long-term results before considering additional body contouring.

While a full tummy tuck offers aesthetic advantages, starting with a panniculectomy could be a great first step toward your transformation—especially if it’s covered by insurance. I recommend speaking with a board-certified plastic surgeon who accepts Medicare and has experience with post-weight loss body contouring. They can help you navigate the insurance process and determine the best surgical plan for your goals.

Check out this video below of a panniculectomy that completely transformed this man's life.

I hope this helps, and best of luck on your weight loss and surgical journey!

Sincerely,
Dr. J. Timothy Katzen, MD, MBA, FACS, FICS

Tim Sayed, MD, MBA, FACS · Answer

Your photo suggests you are a candidate for panniculectomy, which is distinct from a cosmetic abdominoplasty. Panniculectomy removed the tissue apron that overhangs and results in rashes and skin-on-skin contact in the pubic area. This results is removal of significant weight, and improves local hygiene. It is not a cosmetically-oriented operation and does not include muscle tightening or other cosmetic tummy tuck maneuvers. You would likely be required to lose weight to bring your body mass index (BMI) more in line with cosmetic surgery guidelines before most plastic surgeons would consider doing a purely elective abdominoplasty. However, panniculectomy is likely to be covered by Medicare when done by a participating surgeon and with proper documentation of the symptoms that create medical necessity.

Curtis Wong, MD · Answer

should be able to help you with a panniculectomy (not a tummy tuck) that only removes the hanging skin to eliminate the skin on skin contact.  It is not a cosmetic procedure and your photos suggest you are NOT a good candidate for a cosmetic tuck.  See what surgeons locally participate with Medicare and ask your primary doctor for a referral.

Edward J. Domanskis, MD (in memoriam) · Answer

I do everything possible to get my patients that are after large weight loss covered for their surgeries. Sometimes, if it covers a portion of it, then the patient may have to pay for the other part to get her the best results, like putting the muscle together, making  the scar in area most presentable to the patient, doing a pubic lift, liposuction, extended TT. I am president of the American Society of Bariatric Plastic Surgeons and breast and body contouring after large weight losses is my specialty. Please come in for a consultation so we can helf complete your journey!Dr. Edward Jonas Domanskis is Certified by the American Board of Plastic Surgery 1441 Avocado Avenue, Suite 307 Newport Beach, California 92660 949.640-6324/1.888.234-5080(Ca) FAX- 949.640-7347 Assistant Clinical Professor of SurgeryWOS-Plastic,University of California (Irvine) Orange County’s Physician of Excellence/America’s Top Physicians/Top Doctors Plastic Surgery- 2005-2017 President,American Society of Bariatric Plastic Surgeons
Organoderm Skin care/ScaRxTape

Will a plastic surgeon accept Medicare for my surgery? (Photo)

Answers (4)

Answer: Will MediCare help pay for my TT after large weight loss and will a plastic surgeon accept this?

Answer: Will MediCare help pay for my TT after large weight loss and will a plastic surgeon accept this?

Recommended reading

Everything you need to know about Body Lift

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

Will a plastic surgeon accept Medicare for my surgery? (Photo)

Answers (4)

Answer: Will MediCare help pay for my TT after large weight loss and will a plastic surgeon accept this?

Answer: Will MediCare help pay for my TT after large weight loss and will a plastic surgeon accept this?

Browse related questions

Recommended reading

Everything you need to know about Body Lift

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