Will insurance cover skin removal after weight loss

Performing the hard work to get to a healthy weight can be a fulfilling experience for many patients, but losing weight is only one part of the battle. Often, those who have lost a significant amount of weight are left with sagging skin, and exercise is not the solution to that problem.

Fortunately, the cosmetic surgery community has developed many effective procedures that help get rid of the by-product of significant weight loss. For patients who have experienced such dramatic weight loss, a body lift procedure can remove excess skin and create definition in areas that once held excess fat.

The first question I tend to get from prospective patients is, “Will my insurance cover this?” Many people believe all cosmetic procedures are elective and, therefore, need to be paid out of pocket. However that is not the case for a body lift, as the majority of health insurance companies cover at least part of the procedure.

Although insurance companies are not in the business of paying for cosmetic procedures, some body contouring procedures are considered necessary to improve a patient’s overall health. While I have found that the qualifying criteria for such procedures can be strict, the option is still available. Therefore, I walk my patients through the following list to determine whether their health insurance may pay for part — or all — of a body lift.

Bariatric surgery

If the patient underwent surgery at least one year ago, a health insurance policy may help cover body-contouring surgery.

Significant weight loss

Patients who have lost more than 100 lbs are more likely to have their insurer help cover the costs of a body lift procedure.

Stable weight

Many health insurers require proof that a patient has not only lost the weight, but also managed to keep it off. If a patient has maintained a stable weight for 6 months or more, it is likely that the insurer will assist in paying for the surgery.

Skin disorders

Excess skin can create health concerns such as chafing, rashes, ulcers, and infections. If a patient experiences any of these issues, and other forms of medical treatment have been unsuccessful, then one’s insurer may cover the removal of excess skin.

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Still, other aspects of a body lift procedure such as breast augmentation are considered elective surgery and would be an out-of-pocket expense. Since each health insurance policy is different, the only way to find out whether a patient’s body sculpting procedure would be covered is to consult with the insurer.

Regardless of the method of payment, it is our job to help patients take the next step in their weight loss journeys to truly look and feel their very best.

Robert T. Grant, MD, MSc, FACS, is Chief of the combined Divisions of Plastic Surgery at New York-Presbyterian Hospital-Columbia University Medical Center and New York-Presbyterian Hospital-Weill Cornell Medical Center. He is also Associate Clinical Professor of Surgery in the College of Physicians and Surgeons at Columbia University and Adjunct Associate Professor of Clinical Surgery at Weill Cornell Medical College. For more information about Dr. Grant or to contact him, visit his website at www.robertgrantmd.com.

 I see a lot of folks, both men and women, who have had gastric bypass or a lap band and experienced what we call ‘massive weight loss’. Typically this is a weight loss of over 100 pounds. Universally, if you are in this group of patients, you will have loose skin on your neck, upper arms, breasts, flanks, back, tummy and thighs and this picture probably looks pretty familiar . The loose skin can be a problem not only due to rashes and skin care issues, but because a lot of patients tell me they still feel heavy with all of the loose skin still there. Commonly performed treatments are skin reduction of the arms (brachioplasty), breasts (lifts and reductions), tummy tucks, and thigh lifts. In today’s times, these procedures are almost always considered “cosmetic”. This translates into no insurance coverage. Over the last 18 to 24 months, at least in my office, we have seen almost a 100% denial rate when we seek insurance pre-approval. If you are considering one of these procedures, my advice is to go into the process assuming you will have to cover the cost yourself. Now, that being said, the costs usually aren’t as high as most folks assume. I have people tell me all the time that they assumed the costs would be in the $20,000 to $30,000 range. The reality is that it is no where near that much. For instance, an arm procedure is about $5,000 total cost. A tummy, about $6,600 and financing options are available. Why no coverage? Well, loose skin removal is simply not considered “medically necessary” by third party payors. Period.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

All posts on this blog are authored by Louisville weight loss surgeon Dr. Lee Corbett. Dr. Corbett specializes in cosmetic plastic surgery including  body lifts, liposuction,  and tummy tucks.