During the past decade, weight-related health issues like Type 2 Diabetes, sleep apnea, and heart disease have taken center stage in the United States. Health insurance companies have taken note – some would say begrudgingly – offering to cover requested surgeries by members looking to increase their health by decreasing their weight.

But while most insurers will cover bariatric surgeries such as gastric bypass and even gastric banding, few ¬– if any – cover the necessary cosmetic surgeries that follow procedures. For patients with limited incomes, this leaves them with few options. They are left in a healthier situation, but aesthetically, with a new problem.

Bariatric surgery is usually considered a “final step” by insurance companies. All of the 43 companies surveyed for this story cover various bariatric surgeries, but only after previously documented weight-loss attempts. Following bariatric surgery, most patients are left with large amounts of abdominal, neck, and arm skin. While the body quickly cannibalizes the stored sugars in the fatty layer, the outlining skin remains the same, which is why many patients seek to have body lift procedures.

To remove this skin around the abdomen, the most common area of need, patients must have one of two procedures: a panniculectomy or an abdominoplasty. Neither is covered by most insurance companies unless a medical need is determined. Those include impediment to walking and persistent rashes caused by the rubbing of overlapping skin.

A panniculectomy is the simplest of the two procedures. A surgeon essentially removes excess skin and sutures it back together. An abdominoplasty, commonly known as a tummy tuck, includes skin removal as well as tightening of abdominal muscles. Regardless of the surgery, nearly all health insurance companies consider them to be cosmetic and do not cover them.

The average cost of a tummy tuck, according to the most recent results from the
American Society for Aesthetic Plastic Surgery, the average cost of a tummy tuck is $5,300. Although the ASAPS did not have average costs for a panniculectomy, an Internet search provided a range of $5,000 to $10,000, depending on the amount of skin to be removed.

Patients looking to increase their health through surgery should expect their health insurers to ask for plenty of documentation before a procedure. But convincing them to cover cosmetic procedures following a bariatric surgery will more than likely prove fruitless. Patients can expect to be lighter in the end, but to be healthier AND look good, they should expect their bank accounts to be lighter as well.