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does medicare cover skin removal surgery

Does Medicare Cover Skin Removal Surgery?

Losing weight is not the easiest thing in the world. And even when you’re successful at it, there are still problems to deal with.

One of them is excess skin sagging. This excess skin can cause rashes, and even worse, infections.

People dealing with this issue can turn to surgery to remove the excess skin.  So a common question many people have is, “does Medicare cover Skin Removal Surgery?”

In this article, we answer this question in clear, plain English. You will also find the average costs of skin removal surgery, as well as other helpful info.

Does Medicare Cover Skin Removal Surgery?

The short answer is yes; Medicare will cover the cost of skin removal surgery. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met for Medicare to pay for your skin removal surgery. Below we look at what these are so you know what to expect.

Original Medicare (Medicare Part A and Part B) provides coverage for skin removal surgery. However, Medicare will only cover the cost of a skin removal surgery if it is medically necessary. So if the excess skin is having a negative impact on your life, talk to your doctor.

There are some requirements that must be met in order to get coverage. These are:

  • The excess skin impacts your daily movement
  • You have a skin condition that threatens the health of your skin
  • A stable weight for 6 months before the surgery
  • Your BMI has to drop 5 or more points

Medicare Advantage plans (Medicare Part C) also provides coverage for skin removal surgery as they cover everything Original Medicare covers. However, out-of-pocket costs will vary depending on the specifics of your plan.

How Much Does Skin Removal Surgery Costs?

The average cost of skin removal surgery averages around $11,500. There are generally other extra costs involved including anesthesia and hospital care.

What Is Skin Removal Surgery?

Skin removal surgery, or also known as panniculectomy is an invasive surgical treatment that aims to remove large amounts of excess skin on the lower part of the belly. This surgery can help people who underwent weight loss and are left with excess skin.

Large amounts of excess skin can cause rashes, infections, and ulcers under the excess skin if they are not removed.

During the procedure, the surgeon will make two cuts into the abdominal wall. This is to remove the excess skin in the middle. The bottom part of the skin will then be reattached to the top part through suturing. The procedure usually takes two to five hours.

As long as you maintain your weight, follow-up surgery is not necessary. The result of a skin removal surgery is considered to be permanent.

On the other hand, recovery after the surgery can be slow. After the surgery, you may experience pain and the sutured skin may feel numb for the next few weeks.

You are eligible for a skin removal surgery if you met at least one of the following:

  • Underwent a huge amount of weight loss which resulted in having a loose belly skin
  • Having hygiene problems due to excess skin, mostly down on the pubic region.
  • Excess skin is causing skin issues such as ulcers or rashes.
  • Underwent gastric bypass or bariatric weight loss surgery

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover podiatry?

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