Will I qualify for a panniculectomy on medicaid? (Photo)

Question

Hello I am a 26 year old female. I weigh 260 pounds. I struggle with a lot of hanging skin on my belly. I've had 3 c sections and I think they have really put a toll on my stomach. I have superior medicaid. I'm trying to see if I qualify for a panniculectomy. I called a surgeon, they said they do accept insurance for the procedure but I need to get a referral. How would I go about getting a referral from a doctor? What would I say? How can I get them to give me one? Would I qualify with my weight ?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether you will qualify for a panniculectomy on Medicaid. There first thing you need to do is see your primary care doctor. This is usually called a general practitioner or an internist. Once you see your internist, they can refer you to a plastic surgeon for panniculectomy. Typically your GP or internist will write a letter on a prescription pad to the plastic surgeon referred for panniculectomy. When you visit the doctor, you will need to describe your symptoms. Many people have symptoms with an overhanging abdomen or pannus are chronic skin infections that cannot be treated with antifungals, antibiotics, creams, and pills.
In addition, many patients with a large abdominal pannus have low back pain and knee pain. Patients also have a hard time exercising due to the sheer size of their abdomen. In terms of qualification, this is entirely dependent on Medicaid. Often time, they do not even give prior authorization. That means Medicaid does not approve the surgery before you have the surgery. Medicaid sometimes decides to pay after the surgery. That means after the surgery, if you qualify, they will accept and pay for the surgery. However, if you do not qualify, they will not pay for the surgery. Therefore you must discuss coverage before the surgery. It will help if you are also concerned with your surgeon if the surgery is denied after the procedure. I hope this helps to answer your question about whether you qualify for Medicaid. 
 If you cannot find an experienced, panniculectomy or lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Daniel Barrett, MD · Answer

Dear Thrifty680018,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you 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

Will I qualify for a panniculectomy on medicaid? (Photo)

Answers (2)

Recommended reading

Everything you need to know about Panniculectomy

Our mission is to create a world where every investment in modern beauty is Worth It.

Will I qualify for a panniculectomy on medicaid? (Photo)

Answers (2)

Browse related questions

Recommended reading

Everything you need to know about Panniculectomy

Our mission is to create a world where every investment in modern beauty is Worth It.