A small subset of liposuction procedures may be covered if there is medical proof of the necessity, but this is rare and patients should expect to pay all liposuction costs out-of-pocket unless certain medical conditions are met.
Patients should check with their insurers about requirements for medical necessity to qualify for this very limited potential coverage exception before undergoing any liposuction procedures.
Some Reasons Liposuction May Potentially be Covered by Insurance:
- If there’s proof that extra fat in one area is causing pain or health problems, you need to show documents to prove it’s necessary for medical reasons.
- Sometimes, if a man has really big breasts due to a condition called severe gynecomastia, insurance might cover liposuction to remove the extra breast tissue. But only if it’s seriously affecting mental health and quality of life.
- Rare health issues like lipedema or Dercum’s disease cause fat to build up strangely and don’t respond to diet or exercise. In these cases, liposuction might be covered if strict criteria and documentation are met.
- Liposuction could be approved if it’s part of reconstructive surgery needed after procedures like mastectomy or lumpectomy. This is when body contouring is necessary for the complete reconstruction process.
- If abnormal fat distribution is causing other chronic health problems like sleep apnea or diabetes, insurance might consider covering liposuction if strict documentation proves it’s medically necessary.
Most of the time, health insurance in the United States considers liposuction to be a choice made for appearance rather than a necessary medical procedure. This means that people usually have to pay for liposuction on their own.
If there’s a real medical need for liposuction, there’s a chance insurance might cover it, but it’s not easy. You have to prove that there’s a health issue, show that other solutions won’t work, and demonstrate that the problem is likely to get better with liposuction.
In short, getting insurance to cover liposuction is often a difficult task for those wanting to get rid of unwanted fat.
Richard t
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