Does Medicare Cover Liposuction? 

Liposuction, also known as lipoplasty or body contouring, is generally considered a cosmetic surgical procedure that removes fat from parts of the body, like the abdomen, hips, thighs, upper arms, neck, or buttocks.  

However, there are several instances when physicians may suggest using liposuction for medically necessary reasons, which can include the following:

• For the removal of benign fatty tumors known as lipomas 
• To remove excess fat in men with enlarged breasts, a condition called gynecomastia 
• To remove fat tissue in the case of abnormal fat distribution known as lipodystrophy 
• Because of excessive sweating known as axillary hyperhidrosis – surgeons use liposuction to remove eccrine sweat glands 
• For breast reconstruction after a mastectomy for breast cancer 
• To repair or improve the function of a malformed body part
• To treat conditions like lymphoedema or lipoedema

If your physician recommends that you get liposuction, coverage through your Medicare insurance will depend on the reason you need this type of procedure and where you have the procedure performed.

How does Medicare cover approved surgeries? 

In general, Medicare doesn’t cover liposuction because it’s most considered as an elective cosmetic procedure. On the other hand, if your physician (who accepts Medicare assignment) certifies that a liposuction procedure is medically necessary to treat an injury or to repair a malformed body part, you may qualify for Medicare coverage. If you or your health care provider feel that you meet Medicare qualification requirements, you (or your physician) can go directly to Medicare to get approval for the liposuction procedure. 

If you qualify for this benefit, Original Medicare Part A (hospital insurance) covers the surgery when you’re admitted as an inpatientin a hospital that accepts Medicare assignment. The admitting physician must also accept Medicare assignment. 

Medicare Part A covers the surgery, a semi-private room, your meals, any prescription medications you need regarding the procedure while you’re an inpatient, physical therapy sessions, and part-time skilled nursing care after you meet the deductible for the current benefit period. 

Even if you are an inpatient with coverage through Medicare Part A, physician and surgeon fees are covered by Original Medicare Part B (medical insurance), and you pay 20 percent of the final approved cost.  

If you have liposuction as an outpatient , the approved procedure is covered by Original Medicare Part B. Part B pays 80 percent of the final approved cost, and you pay 20 percent after you’ve covered your annual deductible. 

How do MA plans cover approved surgeries and procedures?

If you’re enrolled in a Medicare Advantage (MA)plan, you must get approval from Medicare to meet eligibility requirements. All MA plans are required to provide beneficiaries with the same benefits provided by Original Medicare Parts A and B, but most include additional benefits.

Depending on the type of MA plan you have, you may need to use health care providers, physicians, surgeons, hospitals, and other facilities that are included in your plan’s network of approved providers to get coverage. 

Your out-of-pocket costs can also vary depending on the type of Medicare Advantage coverage you have, and which plan you’re enrolled in, so check your plan, or call your provider if you aren’t sure about costs and network restrictions.  

How much does liposuction cost without Medicare insurance? 

The final cost of a liposuction surgical procedure depends on the part of your body being treated and the number of treatments you undergo. Today in the United States, the national average cost for liposuction is $7300, but it can range between $2000 and $7000 for the initial treatment and $1200 to $4000 for each additional treatment.