- Medicare doesn’t typically cover liposuction, since it’s considered an elective cosmetic procedure.
- In rare cases, Medicare may cover a cosmetic surgery like liposuction if it’s medically necessary to treat an injury or to repair a malformed body part.
- Even if Medicare won’t cover liposuction, you may be eligible for other Medicare-covered services.
Liposuction is a type of cosmetic surgery that uses suction to remove fat from an area of your body. Some of the most common areas targeted for fat removal are the abdomen, neck, and buttocks.
According to the American Society of Plastic Surgeons (ASPS), liposuction was the second most common cosmetic surgery performed in the United States in 2019. About 10 percent of these procedures were done on people ages 55 and older.
While liposuction is a popular procedure, insurance providers often consider it an elective cosmetic surgery and won’t cover it. Medicare is no exception to this.
Keep reading to learn more about when Medicare will cover liposuction, your best steps for getting coverage, and more.
Medicare Part C, also known as Medicare Advantage, plans are typically no different. Many private insurance companies, including those selling Part C plans, don’t cover cosmetic surgeries like liposuction.
However, in some limited scenarios, Medicare may cover liposuction. These include situations when it’s viewed as medically necessary to address an injury or condition.
Let’s explore these exceptions in more detail.
Medicare may cover a cosmetic procedure like liposuction for two main reasons. These are when it’s viewed as medically necessary to:
- treat an injury
- repair a malformed body part to improve function
A few examples of when these may apply to liposuction include:
- removing a large fatty growth (lipoma) with minimal scarring
- eliminating fat deposits from the lower limbs of people with lipedema to help improve mobility
- removing fat tissue from the breasts of men with gynecomastia
- getting rid of additional fat that’s accumulated due to lymphedema when more conservative treatments haven’t helped
- taking fat from one part of the body and transferring it to an area impacted by a lipodystrophy syndrome (fat atrophy) to ease physical discomfort
- reducing the amount of fat in people who are morbidly obese to aid in another medical procedure, such as a tracheostomy or colostomy
- transferring fat from one area of the body to an area that’s been impacted by a severe injury or burn
Although you may have a medical reason to get liposuction, you’ll still have to go through Medicare directly to explain why it’s needed and get it approved.
Let’s examine the steps that you can take to make your case to Medicare for coverage of liposuction:
- Talk with your doctor. Ask your Medicare-approved doctor to submit a written request to Medicare or your plan’s provider, explaining why liposuction is medically necessary for your condition.
- Collect additional documentation. Aside from the written request from your doctor, you can collect any supporting documentation that you have about your condition and any previous treatments you’ve tried.
- Contact Medicare. Reach out to Medicare directly via 800-MEDICARE (800-633-4227; TTY 877-486-2048). Explain your situation in detail to see if you’re eligible for coverage. If you have a Part C plan, you’ll need to contact your plan’s provider.
Even if you take all the steps outlined above, it’s still not guaranteed that Medicare will cover your procedure. This is because Medicare has an established policy of noncoverage for cosmetic surgeries like liposuction.
If you’re denied coverage, you can appeal the decision. This process has several steps, which can differ depending on whether you have original Medicare or a Part C plan.
Contact Medicare or your plan’s provider for specific details on initiating an appeal.
If Medicare doesn’t cover your liposuction, you can still have the procedure. In this case, you’ll be responsible for covering all the costs out of pocket, regardless of what type of Medicare coverage you have.
According to the ASPS, the average cost of liposuction was $3,548 in 2019. However, this cost can vary, depending on factors like:
- your location
- your plastic surgeon
- the specific type of liposuction procedure used
Some plastic surgeons may offer a financing or payment plan for your procedure. If you’d still like to have liposuction, this is definitely something to ask about during your initial consultation with a plastic surgeon.
People may seek out liposuction for various reasons. Let’s look at some of the most common ones and explore other potential treatment options.
For a medical condition
If you want liposuction for a medical reason, Medicare may cover other surgical procedures for your condition. Talk with your doctor about your options, as well as how and when Medicare covers them.
For weight loss
If you’re seeking liposuction for weight loss or another cosmetic reason, you have several potential options under Medicare:
- Fitness benefits. Some Medicare Advantage plans offer fitness benefits like SilverSneakers. In fact, a large 2011 study found that SilverSneakers users were less likely to have several chronic conditions and fewer hospitalizations than those who didn’t use the benefit.
- Obesity screening. Medicare covers this service if you have a body mass index (BMI) of 30 or higher. It includes a BMI measurement and behavioral therapy focused on exercise and diet to help you lose weight.
- Nutrition therapy. If you have diabetes or kidney disease, you may be eligible for nutrition therapy. This service allows you to work with a nutrition professional to help manage your diet and other lifestyle factors that may impact your condition.
- Bariatric surgery. Medicare covers some specific types of weight loss surgery. However, you’ll need to meet strict criteria to get coverage.
Dietary and lifestyle tips
If you’re aiming to burn fat quickly, consider some of the dietary tips below:
- Focus on eating foods rich in fiber, vegetables, proteins, and healthy fats.
- Try to cut your carbohydrate intake. This means limiting foods that have sugars, starches, and refined carbohydrates.
- Drinking plenty of water can help keep you hydrated and curb hunger.
- Limit the amount of alcohol you drink, since it can lead to weight gain.
- Make sure you’re eating the correct portion size during meals.
You can also read this article for more details on scientifically proven ways to lose belly fat.
In addition to adjusting your diet, following these lifestyle tips may also help with weight loss:
- Aim to get at least
150 minutesof aerobic exercise — such as walking, running, or swimming — each week.
- Add strength training to your exercise routine; this can help to burn fat.
- Find additional ways to incorporate physical activity into your day, such as choosing to take the stairs instead of the elevator.
- Get plenty of sleep, because poor sleep quality can be associated with weight gain.
- Stress can often lead to overeating. Instead, try to manage your stress through exercise, yoga, or meditation.
For even more lifestyle and dietary ideas for burning fat effectively, click here.
Medicare generally doesn’t cover cosmetic surgeries like liposuction. In the vast majority of cases, liposuction is viewed as an elective procedure that’s not medically necessary.
However, there may be some instances when Medicare may cover liposuction, such as to repair an injury or malformed body part. To get coverage, you’ll have to make a case to Medicare.
If Medicare chooses not to cover liposuction, don’t lose hope. Other services and procedures covered by Medicare may help with your condition. Reach out to your doctor to discuss your options.