While Medicare usually doesn’t cover liposuction, there can be exceptions for medically necessary procedures to treat injuries or fix birth defects. Other Medicare-covered services may also be available.
Liposuction is a type of cosmetic surgery that uses suction to remove fat from an area of the body. The abdomen, neck, and buttocks are some of the most common areas targeted for fat removal.
According to the American Society of Plastic Surgeons (ASPS), liposuction was the most common cosmetic procedure in 2022, the latest year for which data is available.
There were 325,669 procedures that year, a significant increase of 23% from 2019. About 17% of these procedures were performed on people between the ages of 55 and 69, and 2% were performed on people over the age of 70.
That said, insurance providers often consider liposuction elective cosmetic surgery and do not cover it. Medicare is no exception.
Keep reading to learn about when Medicare will cover liposuction, your best steps for getting coverage, and more.
In nearly all situations, original Medicare (Part A and Part B) won’t cover liposuction. This is because it’s considered an elective cosmetic surgery.
Medicare Part C, also known as Medicare Advantage, is typically the same. Many private insurance companies, including those selling Part C plans, don’t cover cosmetic surgeries like liposuction.
However, in some limited scenarios, Medicare may cover liposuction. These include situations when it’s viewed as medically necessary to address an injury or condition.
Medicare may cover a cosmetic procedure like liposuction for two main reasons. These are when it’s viewed as medically necessary to:
- treat an injury
- repair a malformed body part to improve function
If your medically necessary procedure is in-patient, it will be covered by Part A. Outpatient procedures are covered under Part B. Medicare Advantage should offer you the same coverage as Original Medicare.
What type of cosmetic surgery might be deemed medically necessary by Medicare varies from state to state. A few examples of when liposuction might be medically necessary include:
- removing a large fatty growth (lipoma) with minimal scarring
- eliminating fat deposits from the lower limbs of people with lipedema to help improve mobility
- removing fat tissue from the breasts of men with gynecomastia
- getting rid of additional fat that’s accumulated due to lymphedema when more conservative treatments haven’t helped
- taking fat from one part of the body and transferring it to an area impacted by a lipodystrophy syndrome (fat atrophy) to ease physical discomfort
- reducing the amount of fat in people who are morbidly obese to aid in another medical procedure, such as a tracheostomy or colostomy
- transferring fat from one area of the body to an area that’s been impacted by a severe injury or burn
Although you may have a medical reason to get liposuction, you’ll still have to go through Medicare directly to explain why it’s needed and get it approved.
Let’s examine the steps that you can take to make your case to Medicare for coverage of liposuction:
- Talk with your doctor: Ask your Medicare-approved doctor to submit a written request to Medicare or your plan’s provider explaining why liposuction is medically necessary for your condition.
- Collect additional documentation: Aside from the written request from your doctor, you can collect any supporting documentation that you have about your condition and any previous treatments you’ve tried.
- Contact Medicare: Reach out to Medicare directly via 800-MEDICARE (800-633-4227; TTY 877-486-2048). Explain your situation in detail to see if you’re eligible for coverage. If you have a Part C plan, you’ll need to contact your plan’s provider.
Even if you follow all the steps outlined above, Medicare will not always cover your procedure. This is because Medicare has an established policy of noncoverage for cosmetic surgeries like liposuction.
If you’re denied coverage, you can appeal the decision. This process has several steps, which can differ depending on whether you have original Medicare or a Part C plan.
Contact Medicare or your plan’s provider for specific details on initiating an appeal.
If Medicare doesn’t cover your liposuction, you can still have the procedure. In this case, you’ll be responsible for covering all the costs out of pocket, regardless of what type of Medicare coverage you have.
According to the ASPS, the average cost of liposuction is about $4,449. However, this cost can vary, depending on factors like:
- your location
- your plastic surgeon
- the specific type of liposuction procedure used
Some plastic surgeons may offer a financing or payment plan for your procedure. If you’d still like to have liposuction, this is definitely something to ask about during your initial consultation with a plastic surgeon.
People may seek out liposuction for various reasons. If you want liposuction for a medical reason, Medicare may cover other surgical procedures for your condition. Talk with your doctor about your options, as well as how and when Medicare covers them.
That said, depending on your specific needs, there may be other options besides liposuction that Medicare might pay for.
Is Sono Bello covered by Medicare?
Sono Bello is a type of laser liposuction. Like other cosmetic procedures, it’s not covered by Medicare unless medically necessary.
Does Medicare ever cover a tummy tuck?
Like other cosmetic procedures, tummy tucks are generally not covered by Medicare or private insurance unless they’re done for a medically necessary reason.
Learn more: Does Medicare cover plastic surgery?
Does Medicare pay for CoolSculpting?
CoolSculpting is a fat removal procedure that uses extreme cold to freeze fat tissues from specific areas of the body. Since it is a cosmetic procedure, it is not covered by Medicare.
Does Medicare cover laser fat removal?
Laser fat removal uses lasers to heat and remove fat. It is a cosmetic procedure. Medicare does not cover cosmetic surgery unless there is a medically necessary reason for the procedure.
What else does Medicare cover for weight loss?
If you’re seeking liposuction for weight loss or another cosmetic reason, you have several potential options under Medicare:
- Fitness benefits: Some Medicare Advantage plans offer fitness benefits like SilverSneakers.
- Obesity screening: Medicare covers this service if you have a body mass index (BMI) of 30 or higher.
- Nutrition therapy: If you have diabetes or kidney disease, you may be eligible for nutrition therapy.
- Bariatric surgery: Medicare covers some specific types of weight loss surgery. However, you’ll need to meet strict criteria for coverage.
Medicare generally doesn’t cover cosmetic surgeries like liposuction. In the vast majority of cases, liposuction is viewed as an elective procedure that’s not medically necessary.
However, there may be some instances when Medicare may cover liposuction, such as to repair an injury or malformed body part. To get coverage, you’ll have to make a case to Medicare.
If Medicare chooses not to cover liposuction, don’t lose hope. Other services and procedures covered by Medicare may help with your condition. Reach out to your doctor to discuss your options.