Cosmetic surgery can be done on many different areas of the body. Examples of reconstructive surgery done for medical reasons that may be covered (or partially covered) by insurance include: Cosmetic surgery can be quite expensive, especially when you are paying for all of it out of your own pocket. Finding a cosmetic surgeon that you have confidence in and are comfortable talking to is extremely important when you are considering cosmetic surgery or procedures. Cigna's full bariatric surgery coverage statement can be found here. If you decide to proceed with liposuction, make sure to bring up the subject during your initial visit with a plastic surgeon. On average, the cost of liposuction can range from $2,000 to $7,000. The main purpose of liposuction is to reshape one or more areas of your body, not to reduce body weight. Insurance will cover the cost of some procedures if they are considered reconstructive (as opposed to purely cosmetic) in nature. June 14, 2021 / by Dr. Aric Aghayan. Yes, Cigna covers lap band fills as necessary. It may take up to 6 months for the skin to tighten around the treated area. Bariatric procedures like gastric banding, gastric sleeve, gastric bypass and duodenal switch, on the other hand, are categorized as weight loss surgeries and approved obesity therapies. If you are thinking about having cosmetic surgery or a cosmetic procedure, consider the following questions before making a decision. Surgeons understand the reasoning behind insurances failure to cover cosmetic procedures. Lipedema, a condition in which fat deposits in the body swell into the leg, causing bloating and swelling in the legs and, in severe cases, the lower torso, is another major application for liposuction. Cigna also doesn't explicitly cover trunk liposuction (hips, abdomen, and buttocks), but other plans like Aetna also do not state that explicitly, but do cover. This treatment typically caters to eliminating excess fat int he neck, arms, breasts, abdomen, thighs, buttocks, and face. And you may or may not be given a sedative to help you relax. Insurance Plastic Surgery (L35163) 10/01/2019 . 40,000 depending on various factors. Limit how much time you spend in the sun. Take the time to think it through. Read on to discover more about liposuction as it relates to insurance coverage, both private and public. A thorough consultation appointment is the only way to determine how complicated the procedure will be before treatment. People over the age of 55 received about 10% of these treatments. Examples include treating subcutaneous lipomas, lowering high triglyceride levels, or treating heart congestion or cardiac problems. And having a health condition such as high blood pressure or heart disease may increase the risk. Liposuction is one of the most effective treatments we currently have for them. Does Cigna Cover Weight Loss Surgery. A body lift in San Diego typically costs between $20,000 to $25,000. Regarding out-of-network surgeons in states like California and Ohio, Cigna will likely refuse to pay for surgery with them because there are in-network surgeons. You are more likely to be happy with the results of cosmetic surgery if you have clear, realistic expectations and a clear understanding of why you want to have surgery. As the liposuction technique is very rarely used for reconstructive purposes or in life-saving procedures, the medical expenses that incur during the treatment are usually not covered by health insurance. Examples include treating heart congestion or cardiac problems, lowering high triglyceride levels, and removing subcutaneous lipomas. This site does not contain a complete list of all plans or products available. This uses a chemical solution to remove the top layers of skin, allowing new skin to grow. There is a significant difference between cosmetic surgery and reconstructive surgery-. All rights Reserved. Schedule a consultation with a cosmetic surgeon. Best Cigna Health Insurance Plans. Individual policies may vary. View the 2023 Cigna drug lists: Choose a drug list from the drop down menu below to view medications that are commonly covered. Gynecomastia surgery, also called male breast reduction, is done to correct enlarged or overdeveloped breasts in men. and the agents who may contact you are not affiliated with or sanctioned by the U.S. Government or the federal Medicare program. Some common examples where insurance may cover liposuction are-. If you're thinking about purchasing a Cigna plan, read this simplified guide about their different options. *Please note that there is a nonrefundable $100 deposit required for liposuction consultations. Lipomas generally do not cause medical problems or are not harmful to a . In general, it does not require an overnight hospital stay unless a large volume of fat is being removed. Bariatric surgery proceduress covered by Cigna-HealthSpring PPO are: Gastric Stapling. Surgery always involves some risk. Other Policies and Guidelines may apply. But in some people the skin may remain somewhat loose. Liposuction removes fat from your body using suction. This is most likely to occur when a large volume of fluid is injected into the body. Transferring fat from one area to another, specifically the area which is affected due to injury or burn. Your doctor can tell you if your goals are realistic and how best to achieve them. Don't give up if insurance refuses to cover liposuction. Next, a large amount of an anesthetic solution containing lidocaine and epinephrine is injected into the fatty tissue before traditional liposuction is done. However, your type of plan and the state where you live are important factors. If you need liposuction to treat a cancerous subcutaneous lipoma, your insurance company will almost certainly pay for it. Excessive blood and fluid loss, leading to shock. For example, breast reconstruction after a mastectomy is covered, and this coverage is now actually required by law, called the Women's Health and . This cost reflects liposuction in only one treatment area. a listing of the legal entities Yes, it is covered if the first procedure was unsuccessful. When a large weight loss or several pregnancies leave behind extra folds of skin, some people use this surgery for a flatter, smoother stomach. It is most often used to remove wrinkles, superficial skin growths, shallow scars, pigment changes in the skin, and other skin problems. Some people's skin is very elastic and retracts more quickly than other people's skin. The risk of complications increases as the volume of fat removed increases. As a result, insurance excludes items that some people might seem frivolous and only covers the essentials with their health insurance, such as treatment for terminal illnesses, annual examinations, and medical emergencies. Health insurance does not cover liposuction as these policies are not designed for elective cosmetic procedures. Some doctors offices may also allow direct financing. Details, E. Gregory Thompson MD - Internal Medicine. If a large area or volume of fat is being treated, general anesthesia or deep sedation with a local anesthetic may be used. Patients can consult their Explanation of Benefits, received monthly or quarterly from their insurance companies. While your out-of-pocket expenses may be higher, you do not need to choose an in-network provider. During the procedure, small, thin, blunt-tipped tubes (cannula) are inserted through tiny cuts in the skin. Keep in mind that surgeons are professionals, and will only recommend liposuction as a reimbursable therapy if it truly is. Cigna issued a coverage policy for lipedema surgery that is effective as of June of 2021. This is typically how a health plan works, but they can vary: You pay a premium usually monthly. Fillers can restore volume and structure that is lost due to age or weight loss. Why Liposuction Wont Eliminate Your Cellulite, Reconstruct Your Breasts and Your Confidence After Radiation With Fat Grafting, 5 Signs Its Time to Consider Skin Resurfacing. Recovery may take longer if large areas were treated. Speak with your doctor about your options. In laser hair removal, light treatments are used to heat and destroy hair follicles. Fat clots or blood clots, which may travel to the lungs (pulmonary embolism) and become life-threatening. Your email address will not be published. Health Insurance That Covers Ulcerative Colitis, How to Get a Replacement Health Insurance Card, Blue Cross Blue Shield vs United Healthcare. You may be given antibiotics to reduce the risk of infection. Sometimes a surgeon or patient gets lucky, but we can get patients approved for an out-of-network surgeon most of the time and, if not, assist with finding a qualified in-network surgeon. a listing of the legal entities Liposuction also shapes (contours) these areas. Insurance in the United States is meant to operate as cost sharing and risk sharing between the individual and the insurance company as well as between the individual and other individuals in their insurance pool. Liposuction is generally regarded as a cosmetic procedure that is not medically necessary. Improvement is especially seen along the jawline and in the neck. Serious problems are rare, but they can occur. Unless weight loss surgery is specifically excluded from your policy, surgery is covered if the following criteria are met: They are usually harmless, but they can be cancerous and should be treated by a medical professional as soon as possible. On that list, cosmetic surgery comes first, medical procedures performed solely to improve a patients looks. But opting out of some of these cookies may affect your browsing experience. For the best chance of being covered for an out-of-network surgeon, we dont recommend traveling too far from your home state. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. Treatment of severe scars or disfigurement caused by disease, injury, or birth defects. New patient? For people who are unhappy with their overall appearance rather than just a certain part of their appearance, cosmetic surgery is probably not the answer. Do not be pressured into making a quick decision. Get the facts about what to expect from a certain procedure. Liposuction is usually done as an outpatient procedure in a properly equipped doctor's office, ambulatory surgery center, or hospital. Talking with someone who has had cosmetic surgery may raise issues that you had not considered. There are some loopholes that may permit liposuction to be covered by insurance. Fluid may drain from the incision sites for several days. A licensed insurance agent/producer or insurance company will contact you. The individual is at least 18 years of age or has reached full expected skeletal growth AND has evidence of EITHER of the following: You must also show that other methods of medically supervised weight loss programs have failed. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. For individuals who still feel like liposuction is the right choice for them and their goals, there are some options available. Liposuction is a type of cosmetic surgery that removes fat from a specific area of the body using suction. All Cigna policies exclude breast reduction surgery if the only symptoms associated with . On average, the cost of liposuction can range from $2,000 to $7,000. Although death is very rare with liposuction, it can happen. It may be used to treat acne scars and wrinkles around the mouth or to treat an enlarged nose (rhinophyma) caused by rosacea (facial inflammation and redness). Toxic reaction to the injected solution (lidocaine toxicity), especially if large areas or many areas are treated at one time. The laparoscopic (closed, bloodless, bladeless) technique is use to perform bariatric surgery. Does health insurance cover any plastic surgery? For availability, costs and complete details of coverage, contact a licensed agent or Cigna . Learn more about our patients' great experiences. If these documents are difficult to interpret or fail to explicitly state the companies policies on cosmetic procedures used as therapies, patients are encouraged to call the customer service line. Its important to take into consideration that the abdomen is not classified as one area of treatment, and even this large area encompasses multiple regions. Liposuction has been shown to help with medical complications caused by obesity (though it is not a cure for obesity itself), such as cardiovascular congestion and back pain. The surgeon can view the inside of the abdomen without creating a large wound in the patient's abdomen . Regardless of the type of insurance coverage you have, you will be responsible for paying all expenses out of pocket in this situation. Its far better to work with a surgeon who will lower their rates and enter into an agreement with an insurer in advance, so they are treated like an in-network surgeon. Youll have to make a case with Medicare to get coverage. Cigna Health & Life Insurance Co. expanded its coverage of specialized liposuction and will reprocess coverage requests from patients with lipedema whose claims were previously denied, according to a class settlement filed in the Northern District of California. Although liposuction is a common procedure, insurance companies frequently view it as discretionary cosmetic surgery and refuse to pay for it. Scars from liposuction can occur, but they are usually minor. Learn about the medical, dental, pharmacy, behavioral, and voluntary benefits your employer may offer. Affordable plan options, thousands of dentists, and locations to choose from in convenient locations across the U.S.that's why 18 million customers choose Cigna dental insurance. Even if you follow all of the above recommendations, insurance may still not cover for your operation. 1995-2023 Healthwise, Incorporated. 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