Will Medicaid/Medicare will pay for the removal of excess skin? I had gastric sleeve in Feb 2016, and I have already lost 120lbs

Question

My Dr told me when I got to the weight I wanted my insurance would pay for this excess skin to be removed, I'm trying to no if it did how much out of pocket would I pay?

Nelson Castillo, MD · Answer

Thank you for sharing your question and congratulations on your amazing weight loss.  Insurance may cover the cost of a panniculectomy, an operation designed to remove the apron of loose skin and fatty tissue that develops on the stomach with extensive weight loss.  You would need to see an ASPS board certified surgeon and then have them submit your claim to Medicare to see if they would cover the costs.  Best wishes.

Stephen T. Greenberg, MD, FACS · Answer

Hi thank you for your question.  Each insurance company has different protocol on what they will and will not cover.  You would have to contact your insurance company and or have the surgeon's office send in a pre certification to see if your procedure would be covered.  Best of luck to you.

Miguel Mota, MD · Answer

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,

Janet Turkle, MD · Answer

Hello,The surgery you are describing is not typically covered by Medicare or Medicaid. There are financing programs available that might be helpful to you. For more information, check out the web sites of CareCredit and Prosper. Good luck.

Jane M. Rowley, MD · Answer

You may get medicare to cover a panniculectomy but in my experience the compensation is so incredibly low that many plastic surgeons will not accept medicare.  Good luck, Jane

Susan D. Vasko, MD, FACS · Answer

Thank you for your question, and congratulations on your very successful weight loss! Insurance companies will sometimes cover a Panniculectomy - surgical removal of the "apron" of excess abdominal skin and tissue following extreme weight loss. Your best bet is to schedule a consultation with a board-certified plastic surgeon who will perform a careful examination and let you know what kind of medically-necessary documentation you will need to provide regarding any underlying medical issues such as chafing or rashes beneath your abdominal skin.

Aldo Guerra, MD · Answer

The process of having medicaid and medicare to cover this type of procedure is long and there's no guarantee they will do it. Work with your doctor, but don't be surprised if you're denied unless you can show significant medical problems. Good luck, Dr. ALDO :)

Bhupesh Vasisht, MD · Answer

Medicaid and medicare likely will not cover this procedure.  However, they make a distinction between what is called a panniculectomy vs a belt lipectomy or tummy tuck.  Panniculectomy is the simple removal of excess skin with little to no contouring component.  Your best bet is to have a local plastic surgeon take a look and see how much work needs to be done to help you.  If you want this done and done correctly make sure you see someone who has lot of experience with this surgery.  hope this helps.  Good luck and congratulations on your weight loss.

S. Tyler Elkins-Williams, MD · Answer

What you are describing is called a "panniculectomy" - this is limited to removal of the excess overhanging skin after weight loss. All insurance has slightly different criteria for approving this operation. Just improving your aesthetic contour is typically not covered. You have to demonstrate effects to your health - such as recurrent rashes, or interference with your activities of daily living. 
Most insurance approvals for this operation also require photographs, and for your weight loss to be completed and stable for at least several months. 
The best way to check is to get an appointment with a Plastic Surgeon, have them take photographs and work with you for the approval process. Out of pocket costs can vary widely, depending on your geographic region, how much skin needs to be removed, and in what setting your surgery could be performed (office vs. hospital, etc). RealSelf does have some tools to approximate average costs by the procedure. 
Be aware that a cosmetic Tummy Tuck operation is never covered by insurance; this operation has more steps than a Panniculectomy, but may not be necessary for you. Seeing a Plastic Surgeon for an in-person consult is the only way to know for sure!

Mel T. Ortega, MD · Answer

For any Plastic Surgery medicare will not cover for the procedure. Cost varies by Location, Anesthesia, Surgeon, Etc.Choose a board certified plastic surgeon who has done a ton of Tummy Tuck and has privileges to do this surgery at a local university hospital. This says his credentials have been checked out by fellow Drs. All surgeries carry risk, talk to your plastic surgeon and choose one wisely.Many surgeons, including myself, offer online virtual consultations where you send us your photos and we can estimate the cost. I, like many surgeons, also offer free consultations so that you can be examined and given the most accurate quote possible. Please be mindful that the in person physical exam is the most important and could potentially alter your treatment plan.

Will Medicaid/Medicare will pay for the removal of excess skin? I had gastric sleeve in Feb 2016, and I have already lost 120lbs

Answers (12)

More Tummy Tuck Questions

WE SEND PRETTY
EMAILS

Answers (12)

More Tummy Tuck Questions

Am I a good candidate for a reverse tummy tuck? (Photo)

How long after having a tummy tuck can I start doing sit ups/crunches?

Suddenly swollen 4 weeks post tummy tuck.

Can I get my apron removed without losing weight?

I am concerned about fat redistribution after tummy tuck. I am a body builder and intentionally gain weight to gain muscle mass?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS