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