Congratulations on your extreme weight loss. Sorry, but it seems unlikely medicare or medicaid will cover plastic surgery. Insurance might cover a panniculectomy though. Every country has different rules and regulations when it comes to insurance. Unfortunately, a tummy tuck is not covered by insurance in the US. In other places like Brazil, insurance covers some TTs in qualifying patients when performed in teaching hospitals. Removal of excess skin or a panniculectomy may be covered by insurance. The problem is that this essentially only part of a TT, it will only get rid of the excess skin in the lower abdomen and it will not correct muscle separation. You can also look into medical tourism, it gives people more access to medicine worldwide. Traveling for surgeries, be that out of state or abroad, can be a good idea as long as you do your research. You might be able to find a good deal. If you are traveling, make sure your Plastic Surgeon is Board Certified and is accessible before and after surgery. Best of luck on you research,Sorry, hope this helps,