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Is liposuction ever covered by health insurance?

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The lowdown...
  • Most insurance companies will not cover liposuction because it is cosmetic surgery
  • In some cases, doctors might perform tumescent liposuction during a breast reduction procedure
  • Breast reduction might be covered by health insurance if breast size is causing physical problems
  • Insurance companies might cover other weight loss surgeries if candidates

Most health insurance companies will not cover liposuction because it is considered an elective procedure. However, you can choose to pay for the surgery in cash. The cost might be different at each surgery center depending on the location of the procedure and the provider performing it.

If you are only receiving treatment for one area, it will be less expensive than surgery on multiple areas. Some surgeons will charge one fee for everything involved leading up to the surgery, including anesthesia, while other surgery clinics will charge individual fees. The cost for one area can range in price from $2,000 to $8,000.

If you choose to get elective liposuction, do not pick your surgeon based solely on the price. It is important to choose a surgeon because you trust their skill. If liposuction is considered medically necessary for you, like in the case of breast reduction, your insurance company may cover it. Check with your insurance plan to find out exactly what is covered.

When seeing whether or not a medical condition is covered by your health insurance plan, it’s a good idea to also compare free health insurance quotes online. Not only can you potentially discover great coverage through a new provider, but you could also save thousands of dollars a year with a more affordable plan!

Click here to enter your code and compare quotes right here on our site!

Is breast reduction surgery covered by health insurance?

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Some women experience back pain due to their large breast size. Insurance companies will often cover breast reduction surgery if it is medically necessary to alleviate this pain. Breast reduction surgery may be accomplished using a tumescent liposuction procedure. In this case, your insurance company might reimburse you for the liposuction fees.

Certain insurance companies may impose restrictions on when and where you can get the surgery if they choose to pay for it. You might need to get the surgery pre-approved. Call your insurance company and ask if a prior authorization is necessary.

If you do not get the required approval, there is a good chance your insurance company will not pay for it. Additionally, some insurance companies might require you to use a surgeon within your network.

Does Medicare cover other weight-loss surgeries?

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Although Medicare does not cover liposuction, it does cover other types of weight-loss surgeries. Medicare will cover gastric bypass, lap band, or a duodenal switch if you meet certain requirements. Some Medicare plans also cover sleeve gastrectomies.

In order to qualify for weight-loss surgery coverage, you must have a body mass index over 35 and provide documentation or evidence that you have been at that weight for five years or more. You also must have another medical issue, such as hypertension or Type II diabetes, because of your weight.

Additionally, you must prove that you have tried more than one alternate weight loss program and been unsuccessful. Your primary care physician must also approve of and recommend the surgery, as well as provide evidence that your obesity is not a direct result of a medical disorder.

Does Medicaid cover other weight-loss surgeries?

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Medicaid also covers weight loss surgeries for those who meet the right criteria. The requirements are similar to the ones set forth by Medicare.

Medicaid has slightly stricter regulations for those who are younger than 21. Your body mass index must be 40 or over, as opposed to the standard 35. Additionally, surgery will not be performed at all on females under the age of 13 and males under the age of 15.

Patients must understand that they must change their diet and exercise routine and nutritional counseling must be available before and after the surgery.

If you have been diagnosed with malignant cancer or inflammatory bowel disease, have used steroids for an extended period of time, or you require psychological counseling that might affect your ability to change your lifestyle, it is unlikely that Medicaid will cover your weight loss surgery.

Will my private insurance cover other types of weight loss surgeries?

Many private insurance companies cover weight loss surgeries as well. For example, United Healthcare will cover several types of surgery including Vertical banded gastroplasty and Biliopancreatic bypass in addition to gastric bypass and lap band surgery. If your body mass index is over 40, United Healthcare does not require an additional diagnosis in order to qualify for surgery coverage.

If your body mass index is over 40, United Healthcare does not require an additional diagnosis in order to qualify for surgery coverage.

Is liposuction ever covered by health insurance?

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In most cases, health insurance will not cover liposuction because it is an elective procedure. If you qualify for medically necessary tumescent liposuction to help fix problems associated with breast size, your insurance company may reimburse the cost. Many insurance companies are willing to pay for weight loss surgeries, such as lap band and gastric bypass if you meet the criteria.

Many insurance companies are willing to pay for weight loss surgeries, such as lap band and gastric bypass if you meet the criteria.

Find health insurance providers in your state by entering your zip code below. With free quotes, you can compare various levels of healthcare coverage and get in touch with live representatives that can help you find a plan that covers your needs without breaking the bank.

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