Postbariatrics: Excess skin removal covered by insurance?
At MOOI Clinic, a combination of insured care and uninsured care is possible with a treatment. At MOOI Clinic, we’re often asked if excess skin removal is covered by health insurance. In some cases, this procedure is (partially) reimbursed. Read more about it here.
Have you undergone significant weight loss, such as after pregnancy, adhering to a strict diet, or through procedures like gastric banding or stomach reduction? If so, excess skin around your belly, breasts, arms, or legs may be a concern and may also be affecting your self-esteem. Consider the benefits of contouring surgery to remove the excess skin so you can regain your confidence and a toned appearance.
In most cases, this surgery is not covered by your health insurance company. But there are some exceptions where skin removal can be reimbursed by your health insurance company.
Compensation for excess skin after extreme weight loss
Whether you can be reimbursed for this procedure, to remove excess skin, depends on your own health insurance company and their terms and conditions. Your health insurer uses the Pittsburgh Rating Scale (PRS) to make this determination. Using standard photographs, the degree of excess skin is measured on a 4-point scale (0 to 3, where 0 is normal). Plastic surgery is reimbursed only if you fall into the worst scale: 3. You first need a referral from a primary care physician or medical specialist.
Unfortunately, in many cases, insurance will not cover surgery even though you have a lot of excess skin. In that case, you can visit MOOI Clinic and speak to one plastic surgeons.
What to do?
- Consult your health care policy
- Do you believe you qualify for insured care? Ask your family doctor for a referral to the plastic surgeon at the hospital.
- Referred by the family doctor? Contact the hospital. Treatment with one of our plastic surgeons takes place at the hospital: Zuyderland in Sittard or Heerlen, the MUMC+ in Maastricht, or the VieCuri in Venlo.
- No referral or approval authorization? Then you’re not eligible for (partially) reimbursed care. In this case, we can perform the entire treatment at MOOI clinic. Contact us.
* Consult your health care policy. To qualify for reimbursement, your situation must meet certain criteria. In addition, there may be maximum reimbursement and payment of the mandatory deductible.