Your Insurance: Medicare and Medicaid
Although we have been successful over the past four years in obtaining coverage for Medicare and Medicaid patients, we are not accepting any new Medicare or Medicaid plan members, including Medicare Advantage.
For Medicaid, it is usually not impossible to get out-of-state coverage. So, your only option is if your state has a surgeon who treats lipedema safely. However, the failure of insurers to pay surgeons fairly makes most surgeons unwilling to work with Medicaid patients.
With traditional Medicare, more hospital system-based network surgeons need to treat lipedema before we can enable coverage. Medicare Advantage plans, including Aetna which have paid non-network surgeons decently, are trying to pay surgeons much lower Medicare-based rates. So, it is almost impossible to find surgeons who are willing to treat patients.
We are Looking for More Surgeons
We are certain that in the coming year there will be more plastic surgeons willing to treat lipedema. However, ensuring they are paid fairly for Medicare and Medicaid patients is an important step in making them comfortable including lipedema as a part of their practices. We are advocating behind the scenes to find surgeons who might be willing to operate in the current situation. We are also working with state and federal officials to raise the rates of payment.
What You Can Do Now
In the interim, remember, the challenges we are open about are present regardless of your surgeon and any surgeon who tells you differently might be more focused on making money, not on patient care. Never pay cash upfront for surgery, especially if you have Medicare or Medicaid. Your chances of reimbursement are minimal at best. If you find a surgeon in your state willing and able to do large volume liposuction in a safe setting, let us know. We can help explain to them how to get fair insurance payment.
Don’t give up. Continue your conservative treatment measures. Join our Facebook group, like our Facebook Page, or follow our Instagram. We will make announcements when we have better news.
This page was updated on 12 March 2022
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