Will my insurance pay for a panniculectomy and am I a good candidate? (Photo)

Question

I had a c-section in 1999 then a total hysterectomy in 2018. The bottom of my stomach hangs. Will I be a good candidate?

Kenneth Hughes, MD · Answer

Some insurance companies do not require a specific BMI to cover a panniculectomy.  Instead, they consider medical criteria such as chronic skin rashes, wounds, infections, odor, and other medical issues.
The panniculectomy will produce the best results with the lowest risk of complications during and after surgery if you have lost most of your excess weight or your weight loss has stabilized for a period of six months.  You may qualify for weight loss surgery if your BMI is over 35 and you have a serious weight-related health problem, such as high BP, severe sleep apnea, or type 2 diabetes.
Consult with a board certified PS in your geographical area.

Daniel Barrett, MD · Answer

Dear tblackrinse1,
it is hard to tell for sure without an examination. If you have a history of symptoms caused by your pannus, there is a chance that your insurance will cover the cost. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Robert L. Kraft, MD, FACS · Answer

The carrier will have standards listed on its website. Some require that rashes under the pannus be refractory to IV antibiotics over the course of a year. Others may be different but insurance companies really do not want to pay for cosmetic surgery and have excluded quite a lot, especially with the exponential growth in bariatric procedures.

Will my insurance pay for a panniculectomy and am I a good candidate? (Photo)

Answers (3)

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