Are Body Lift Procedures Covered by Health Insurance?

JULY 17, 2014
Robert T. Grant, MD, MSc, FACS

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.

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