Loose skin is common after significant weight loss. When skin stretches to allow for extra weight, it often loses its elasticity. It may not return to its original shape once the weight is lost. Skin removal surgery can help remove excess skin, but these procedures can be expensive and might not be covered by insurance.

“I have loose skin from my weight loss surgery,” one MyObesityTeam member shared. “The only permanent fix is skin removal, which isn’t covered by insurance unless it’s medically necessary.”

Whether you want excess skin removed for medical reasons can affect your health insurance coverage. This article explains your options, including how coverage decisions are made and what to know if you’re paying out of pocket.

Is It Medically Necessary or Cosmetic?

People undergo skin removal surgery for many reasons. For some, sagging skin affects their self-esteem after weight loss. For others, it can interfere with quality of life or lead to health problems like rashes and infections. Some people have more than one reason for seeking surgery.

One MyObesityTeam member shared, “I finished my weight loss journey. I lost all I needed to lose and had the excess skin removed. I’m thrilled that I decided to get the excess skin removed. It was necessary for my health and mental well-being, as well as my self-image.”

Whether a surgical procedure is considered medically necessary or cosmetic can make a big difference. Most insurers will only pay for medically necessary skin removal procedures. This distinction can be confusing. Some medical and cosmetic procedures sound similar but are treated differently by insurers.

For example, a panniculectomy is a surgery that removes excess fat and skin from the lower abdomen. This overhanging skin can cause problems like painful rashes, skin infections, chafing, and back pain. It may also limit mobility and make it hard to keep the area clean and dry. Because of these health-related issues, this surgery may be considered medically necessary and be covered by insurance.

An abdominoplasty, commonly known as a tummy tuck, also removes excess abdominal skin. However, it goes a step further by tightening the abdominal muscles for appearance. During this procedure, the surgeon also repositions the belly button. While a tummy tuck can improve comfort and self-esteem, it’s usually considered a cosmetic surgery. For that reason, it’s unlikely to be covered by insurance.

If you’ve lost a lot of weight, it’s understandable to want skin removal surgery for both medical and cosmetic reasons. But if you can’t show that the excess skin is causing health problems, you may have to pay the full cost out of pocket.

In some cases, a healthcare provider may be able to make a case for medical necessity. They do this by providing documentation showing that the extra skin is causing specific problems. This may include chronic rashes, infections, mobility problems, or other ongoing issues. This clinical documentation should include dates of visits, diagnoses, treatments provided, and response to treatment.

Estimating Out-of-Pocket Costs

Without insurance coverage, skin removal surgery can cost thousands of dollars. Prices vary widely depending on:

• The type of procedure
• The part of the body being treated
• The amount of skin removed
• The surgeon’s experience
• Your location

For example, the average cost of a panniculectomy in the United States is about $7,000. However, someone in Hawaii may pay around $11,079, while someone in Mississippi may pay closer to $5,918.

Although it may be tempting to shop for the lowest price, cost shouldn’t be the only factor. Choose a board-certified plastic surgeon to prioritize safety and quality outcomes. Opting for a less-qualified surgeon to save money can increase the risk of complications, potentially leading to more procedures and higher expenses later on.

Procedure Costs

Out-of-pocket costs for body contouring procedures can range from a few thousand dollars to well over $10,000. Below are average surgeon fees for common skin removal procedures, based on estimates from the American Society of Plastic Surgeons. Your actual cost may be higher depending on your specific needs, so always ask for an estimate.

• Upper arm lift (brachioplasty) — $6,192
• Thigh lift (thighplasty) — $7,641
• Breast lift (mastopexy) — $6,816
• Lower body lift — $11,397

These figures usually reflect the surgeon’s fee only and may not include other costs.

Additional Fees to Consider

Skin removal surgeries often include other expenses that can add up quickly. Knowing these costs ahead of time can help you plan ahead and avoid surprises. Additional fees may include:

• General anesthesia
• Facility fees for the hospital or surgical center
• Pre-op medical tests or lab work
• Post-op compression garments
• Prescription medications
• Follow-up visits or wound care supplies

When reviewing an estimate, ask whether these costs are included in the quoted price or billed separately.

Before scheduling surgery, ask for a written, itemized estimate from the plastic surgeon’s office. This document will help you understand exactly what you’ll be paying for, compare costs between providers, and budget for the procedure.

Affording Surgery Without Insurance

If your insurance provider won’t cover skin removal surgery, you still have options. While paying out of pocket may require patience and planning, there are several ways to make the cost more manageable.

Payment Plans and Financing Options

Some plastic surgeons offer payment plans and financing options that allow you to pay for surgery over time. A payment plan usually lets you split the total cost into multiple payments instead of paying the full amount all at once. Financing usually involves borrowing money and paying it back with interest.

These options may be offered directly through the plastic surgeon’s office or through a third-party financing company. Be sure to ask about interest rates, monthly payment amounts, length of the repayment period, and any requirement for a down payment.

Medical Credit Companies

Medical credit companies offer healthcare-specific credit cards that can usually be used for surgical procedures. Examples include Care Credit, Alphaeon Credit, and Lane Health. Some plans include promotional periods with low or no interest if the balance is paid off within a certain time frame. Before applying, review the terms carefully to understand the total cost. This is especially helpful if payments extend beyond the promotional period.

Hospital Financial Assistance Programs

If your skin removal surgery is performed at a hospital or large medical center, ask whether they offer financial assistance or self-pay discounts. Some facilities have programs to help reduce costs for people who are paying out of pocket. This is especially true if the procedure addresses ongoing health issues.

Medical Necessity Review

If your insurer initially denies coverage, it may still be worth requesting a medical necessity review or filing an appeal. Ask your healthcare provider for help. They may need to submit a letter. They’ll also be asked to send documentation showing that surgery is necessary because excess skin is causing health problems. This documentation may include photos, medical notes, and records of past treatments for rashes, infections, or other related issues.

Before making financial plans for skin removal surgery, talk to your healthcare provider to make sure you’re a good candidate. You may need to maintain a stable weight for a period of time before surgery. It’s also important to ask about recovery time and expected outcomes. This will help you plan ahead and have realistic expectations going into plastic surgery.

One MyObesityTeam member shared, “I’m finally having surgery to remove the excess skin. I’ve waited 10 years for this!”

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Do you have tips for getting skin removal surgery without insurance? Let others know in the comments below.