Does Medicare Cover Liposuction – Overview?
Liposuction is a type of cosmetic surgery. It involves removing fat from different areas of the body. Liposuction is mostly performed on the tummy, neck, and buttocks.
It is one of the top three most popular cosmetic procedures performed in the US.
Although liposuction is quite popular, most insurance companies consider it as an “elective cosmetic surgery”.
This means that these companies do not provide insurance coverage for the cost of undergoing liposuction surgery. This also includes Medicare.
So, if you’ve wondered whether Medicare covers liposuction, you’ve come to the right place. Let’s check out the details.
How Much Does Medicare Cover Liposuction?
In almost every situation, Medicare Part A and Part B will not cover liposuction costs. The reason is that it is considered to be elective cosmetic surgery, hence not medically necessary.
Medicare Part C (Medicare Advantage) also works similarly. Most private insurance companies do not cover the cost of liposuction. This includes those companies that offer Medicare Part C.
However, in certain scenarios, Medicare does cover Liposuction. These include situations when the procedure is considered to be medically necessary, such as to treat a condition or an injury.
Some common scenarios where Medicare might cover liposuction costs include:
- Removal of a lipoma (large fatty growth) with minimal scarring
- Removal of fatty breast tissue of men with gynecomastia
- Removal of fat deposits from the lower limbs to treat lipedema
- Removal of fat from one area to treat fat atrophy in another area of the body
- Removal of additional fat collected due to lymphedema
- Reduction of fat in morbidly obese people
Even if you have a valid medical reason, you will still need to explain to Medicare directly the reason they should approve your liposuction procedure.
How much does Liposuction Surgery Cost?
In case the liposuction surgery is not deemed medically necessary, then you will have to bear the expenses yourself.
Even in Medicare Part A and Part B cover liposuction when medically necessary, you might still end up paying certain costs.
Medicare Part A and Liposuction
As of 2022, a person with Medicare Part A had to pay around a US$ 1,556 deductible for every benefit period.
This also includes a daily copayment after 60 days in a hospital facility. If you pay a premium for Medicare Part A then this cost will be down to US$ 389 a month.
Medicare Part B and Liposuction
The out of pockets costs of undergoing liposuction with Medicare Part B benefits include paying:
- A monthly premium for a standard amount of US$ 170.10
- An annual deductible of US$ 233
- Around 20% coinsurance for eligible costs
Is there alternative insurance for Liposuction?
In case you have trouble paying healthcare costs with your Medicare Part A and B, then there are other options to seek.
- Medicare supplement insurance – Medigap plans may cover co-insurance costs and the Medicare Part A deductible charges.
- Medicaid – This federal and state insurance program may help people with limited income to bear several medical costs.
- Medicare savings program – These are state-sponsored programs that help you to pay premiums, co-insurance, deductibles, prescription drug costs, and co-payments.
- Supplemental Security Income (SSI) – This is a monthly benefits program for people with restricted income and can help to bear some copayment costs.
Medicare does not offer cover for liposuction if it is meant for aesthetic purposes only. If the doctor considers liposuction as being medically necessary, then you may get some benefits under Medicare Part A and Medicare Part B plans.
As an alternative, you can also choose to buy Medicaid, Medicare savings program, or Medicare supplemental insurance.
These are designed to alleviate the out-of-pocket costs for procedures such as liposuction.