Does Blue Cross Blue Shield Cover Skin Removal

One of the fallouts of weight loss surgery for some patients is the appearance of loose or hanging skin in certain areas of the body. Fortunately, this condition can be successfully corrected with skin removal plastic surgery. Many patients want to know how to get insurance to cover skin removal or is skin removal surgery after weight loss covered by insurance. In this guide, let us look when Blue Cross Blue Shield skin removal surgery may be covered for patients who have had bariatric surgery.

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Will insurance cover skin removal after weight loss

Yes, insurance will cover skin removal after weight loss surgery when certain conditions are fulfilled. Leading insurance providers such as Blue Cross Blue Shield cover plastic surgery procedures when these are performed as a medical necessity, and not for cosmetic reasons. If you are wondering does insurance cover skin removal surgery, here are some of the typical criteria that should be met to obtain this coverage.

  • Weight loss: In general, your insurance company may consider your request for coverage for skin removal surgery if you have lost at least 100 lbs. of excess body weight. This massive weight loss may take place gradually over one to two years following your bariatric surgery.
  • Stable weight: The insurance provider will look at how long your body weight has remained stable following your weight loss. You should have maintained a stable body weight for at least six months (not gained or lost significant weight in this period) to meet this qualifying criterion.
  • Date of surgery: You should know when does insurance cover plastic surgery after bariatric surgery? The answer is: at least one year. In general, to be eligible for insurance coverage for skin removal surgery, at least one year should have passed from the date of your weight loss surgery.
  • Skin concerns: If the excess skin is causing fungal infection, ulcerations, rashes, chafing or pain and discomfort, and your primary care physician recommends skin removal surgery, you may qualify for insurance coverage. You will be required to submit documentation with your application.
  • Body areas: Does insurance cover skin removal after gastric sleeve or gastric bypass for all body areas? No. The most common area that is usually covered for skin removal surgery is the lower abdomen. Apron-like skin (pannus) may hang down in this area, which can be surgically removed.

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Blue cross blue shield skin removal surgery

To know how to get insurance to cover skin removal surgery after weight loss, it is best to speak to your insurance company representative. Every major insurance provider may have slightly different requirements for this coverage. Blue Cross Blue Shield skin removal surgery coverage is usually restricted to panniculectomy procedure, which involves surgical removal of excess skin from the lower abdominal area.

Criteria for coverage may include:

  • The pannus (loose skin in the lower abdomen) hangs at or below the pubic line.
  • The excess skin is causing dermatitis, skin ulcers, or cellulitis, which has not responded to non-invasive treatments for minimum three months.
  • You are suffering from a functional impairment because of excess skin, which can be improved with panniculectomy.
  • The time gap between your weight loss surgery and skin removal surgery (panniculectomy) should be at least 18 months.
  • Your body weight should have remained stable in the last six months prior to your scheduled skin removal surgery.
  • A condition called diastatis recti (“pooch belly”) which occurs because of loose abdominal muscles will not be covered by insurance.
  • To obtain coverage for Blue Cross Blue Shield for skin removal surgery, you will have to submit relevant medical records and/or operative reports, copies of medical consultations, photographs, and other necessary information that support your claim.

READ THIS: Plastic surgery after weight loss surgery

Does blue cross blue shield cover plastic surgery?

Yes, Blue Cross Blue Shield covers certain plastic surgery procedures as long as the procedure is performed as a medical necessity. However, before going ahead with your surgery, you should ask the company’s representative about how to get insurance to cover skin removal or another type of plastic surgery procedure.

In general, Blue Cross Blue Shield covers plastic surgery for the following procedures:

  • Reconstructive plastic surgery that is performed to correct deformities of the body or face caused due to injury, illness, developmental abnormality, or birth defects.
  • Breast reconstruction, septoplasty (nose surgery), cleft palate and cleft lip surgery, and hand reconstructive surgery are some of the commonly covered procedures.
  • Blue Cross Blue Shield for skin removal surgery is covered if it is performed as a medical necessity.
  • Breast reduction and abdominoplasty (tummy tuck) plastic surgeries are covered if the excess skin is causing significant medical concerns or functional impairment.
  • Facelift or facial plastic surgery is covered if it is performed to recover from a burn injury.
  • Breast revision surgery performed because of painful contractures following breast augmentation may be covered.
  • Rhinoplasty is covered by insurance to treat post-traumatic nasal damage or a birth-related nasal defect or deformity.
  • Hair transplant surgery is covered if the permanent hair loss occurred due to trauma, illness, or a previous treatment.

READ THIS: Excess skin removal: Cost, recovery & before and after

Blue cross blue shield cosmetic coverage for skin removal

Bariatric surgery may sometimes result in excess skin in multiple areas, including upper arms, back, breasts, buttocks, and thighs – apart from the abdomen. Although a comprehensive body lift surgery can correct these conditions, but does insurance cover skin removal for cosmetic concerns? The answer is no. Your insurance company will only offer coverage when skin removal surgery is a medical necessity.

Many patients want to know does Blue Cross Blue Shield cover plastic surgery for all body areas. Unfortunately, the BCBS coverage is primarily offered only for panniculectomy to address medical concerns occurring because of excess skin in the lower abdomen. The insurer may also stipulate that only a plan-affiliated surgeon must order and perform the procedure for the coverage to be valid.

Need more info on blue cross blue shield skin removal surgery coverage?

Are you wondering will insurance cover skin removal after weight loss or does Blue Cross Blue Shield cover plastic surgery? We recommend you to speak to your insurance provider for the right advice. At Jet Medical Tourism®, our dedicated team can help you explore low cost surgery options and competitive financing in case you are not eligible for skin removal surgery insurance coverage. For trusted guidance and support, contact us today.