Will Insurance Cover Plastic Surgery Needed After Weight Loss From Lap Band Surgery?
Q: Dr. Eppley, I had lap band 3 years ago and am looking to have excess skin removed, a breast lift and some liposuction in the arms and legs region, just wanting some prices and if my insurance would cover any of it due to being post lap band.
A: To answer your questions, the first thing I need to see is some pictures of what your body looks like. What I am particularly interested in seeing is the size of your abdominal pannus and the degree of breast sagging that you have. But in the interim, let me provide you with some reality about the bariatric surgery patient and and what insurance will or will not do wit the sagging skin that develops afterwards.
1) The only procedure that has any remote chance of being covered would be an abdominal panniculectomy, removal of the abdominal overhang or a simple amputation tummy tuck. But for this to even be considered, a pre-determination letter must be written that describes the medical symptoms the pannus is causing and pictures that show the amount of abdominal overhang. To qualify the pannus must hang over the groin creases and onto the upper thighs and there must be a documented history of treatment for intertrigo. (skin infections under the pannus) Based on this submitted information, it is up to the insurance company to make a decision about coverage.
2) Breast sagging and the breast lift with or without implants is not considered a medical necessary procedure and is not eligible for insurance coverage.
3) It would be extremely unusual for the extreme weight loss patients to benefit by liposuction. The skin quality is often too stretched out to respond well to fat removal alone.
Dr. Barry Eppley