Insurance Coverage for Lipedema

Getting insurance to cover lipedema surgery is now possible. In the past, it was a difficult process that often ended in denials. Not so long ago, insurance companies were not acknowledging lipedema as a legitimate disease. Then came denials because they said liposuction for lipedema reduction was experimental and not a valid treatment. Things have rapidly advanced in patients favor, and currently most insurance companies acknowledge both lipedema and liposuction as a treatment option.  Each insurance company will have its own lipedema policy, and not everyone will cover lipedema treatment. However, most of the major insurance companies are now covering surgical treatment for lipedema reduction.

It is important if you plan to apply for insurance reimbursement that you follow these important tips.

  1. Get a diagnosis made by an experienced lipedema provider, one that knows what to document in their office visit note. At Artlipo we have a practitioner that can make a diagnosis for you.
  2. Make sure you follow the criteria listed in your insurance company’s lipedema policy which usually includes a trial of conservative measures and be ready to have documentation of these things.
  3. Find a lipedema surgery provider and let them know you plan on applying for insurance. Ask if they have staff that can help you, especially an insurance billing specialist that has experience with lipedema. At Artlipo we have our own lipedema insurance specialist.
  4. Be prepared to have denials. It is common to have multiple denials and requests for more information. However, our insurance specialist will work with you the entire way. In many cases, there will also be requests for a peer-to-peer review, that we are happy to accommodate.

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