Is liposuction for lipedema covered by insurance?

Question

I was diagnosed with lipedema a few years ago and it is stage 2 and moving into stage 3. It is getting harder and harder to move around and do even simple tasks. I am afraid of eventually being disabled...I am only 48. My doctor would like me to consider a form of liposuction that has proven successful for other people with my condition. Since my liposuction would be considered a “medical necessity”, is it covered by insurance? What type of documentation do I need to present to my insurance?

Thomas Wright, MD · Answer

Many insurance companies have medical policies that can possibly cover lipedema surgery. The insurance companies very restrictive "medical necessity" and plan restrictions that make it unlikely for many people to get coverage. The individual policies are complex, and the process for submitting for insurance authorization can be lengthy. First, you should get a summary of your plan benefits to see if coverage is even an option. Please know that even when the insurance company covers part of the cost, the patient will usually still have to pay a significant amount.  We are able to get insurance coverage for some of our lipedema patients, however it is getting very difficult.

John L. Burns Jr., MD · Answer

It would depend on your insurance and plan options.  Typically liposuction is considered a cosmetic procedure.

Jason Emer, MD · Answer

It's difficult to answer whether this will be covered by insurance. For best results, I recommend a hi definition procedure like VASER liposuction. I use VASER HI DEF with ThermiRF and fat grafting to get the most fat removal, skin tightening, contour and definition. This combination will give you the most the most improvement. I recommend getting a formal evaluation with a hi definition physique expert. Best, Dr. Emer

Is liposuction for lipedema covered by insurance?

Answers (3)

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