Will my insurance cover a Panniculectomy?

What is the criteria for a Panniculectomy?

You have realistic expectations. You are a nonsmoker. You are bothered by the appearance of your abdomen. You have recurring or persistent rashes or infections underneath the hanging fold of skin.

How do I get my insurance to cover a Panniculectomy?

Since the panniculectomy is not typically seen as a cosmetic surgery, your insurance provider may help pay for the procedure. But, you must meet specific criteria, and the panniculectomy must be seen as a medical necessity. Contact your health insurance provider to discuss your payment options.

Do insurance companies pay for a Panniculectomy?

In many cases, panniculectomy surgery is covered by insurance. In order to qualify, insurance companies often require documentation from medical providers (21)

Why is Panniculectomy covered by insurance?

If surgery is warranted because excess skin or tissue is causing persistent health issues (such as skin conditions, functional deficit, or interference with every day activities), a panniculectomy may be covered by your insurance plan.

How many sizes do you lose with a Panniculectomy?

Most women lose between 2 and 3 pants sizes after a tuck, but there are patients who lose even more. If you had a lot of loose skin before the procedure, for example, you could go down 4 more pants sizes.

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Is a Panniculectomy medically necessary?

Not Medically Necessary: Panniculectomy is considered not medically necessary as an adjunct to other medically necessary procedures such as, but not limited to, hysterectomy, and/or incisional or ventral hernia repair unless the above medical criteria are met. It must also represent a distinct procedure to be reported.

How much weight do you lose after a Panniculectomy?

Results: Average abdominal skin resection was 16.1 pounds, ranging from 10.3 to 49 pounds. Hernia repair was necessary in 13 patients. Additional surgery performed at the time of panniculectomy included skin reduction surgery of the back (40 percent), chest (32 percent), inner thigh (28 percent), and arm (28 percent).

Do you have to lose weight before a Panniculectomy?

Panniculectomies are often performed on adults and, in some cases, adolescents following bariatric surgery weight loss. 3 You should generally be at a stable weight for six months before undergoing a panniculectomy.

What is the average cost of a Panniculectomy?

A panniculectomy is more expensive than a tummy tuck, but it’s often covered by medical insurance. The cost can range from $8,000 to $15,000, plus anesthesia and other extras. A tummy tuck is less expensive but is not covered by insurance. This elective procedure costs on average around $6,200.

Does Blue Cross Blue Shield of Alabama cover a Panniculectomy?

Abdominoplasty, Panniculectomy, and Lipectomy of the abdomen meet Blue Cross and Blue Shield of Alabama’s medical criteria for coverage when all of the following conditions are met: • The panniculus folds hang below the pubis; AND • Clinical records document the presence of symptomatology such as chronic irritation, …

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Is a Panniculectomy the same as a tummy tuck?

Well, there is a difference. In short, a panniculectomy is a medical operation and an abdominoplasty or tummy tuck is a cosmetic operation. During the abdominoplasty, or tummy tuck, not only the skin but the muscles underneath the skin are tightened up.

Under what circumstances will insurance pay for a tummy tuck?

In many cases, a tummy tuck is merely a cosmetic procedure, and most insurance plans will not cover this. However, if you are experiencing rashes or skin infections, it then becomes a medical need to have the surgery. In this case, you may be able to get some of the costs of your tummy tuck covered by insurance.