Lipedema is a medical condition that should be treated with surgery, which should be covered by health insurance. There’s no reason to spend your savings or take out a loan to pay for surgery. It is your right to be covered.
How do I get lipedema covered by insurance?
: You must undergo a functional capability assessment (FCE; also known as a functional assessment of disability). A FCE can help you demonstrate issues you have with sitting, standing, carrying, bending, and other activities of daily living.Only trained Physical Therapists (PT) or Occupational Therapists (OT) can do this exam, therefore you may need to call multiple offices.
Why is lipedema not covered by insurance?
Published study on lymph sparing liposuction for lipedema has been criticized by medical insurance companies in the United States. Although several surgeons in the United States perform the procedure for Lipedema and report significant improvements in Lipedema symptoms and quality of life, the majority of the larger studies published in peer-reviewed medical journals demonstrating the safety and effectiveness of lymph sparing liposuction have been conducted in Europe. Because their medical reviewers are not convinced by the European medical literature on the safety and effectiveness of liposuction or lymph sparing liposuction for Lipedema, most health insurance have chosen not to pay for lymph sparing liposuction for Lipedema. The insurance company may label the treatment “experimental” in this situation.
Insurance companies deny coverage to treat a painful, debilitating condition, wrongfully labeling the treatment as purely “cosmetic
Lipedema is a significant medical disorder that affects about 11% of all women worldwide. Despite the debilitating severity of the ailment and the availability of effective therapies, many Lipedema patients are unable to obtain therapeutic procedures due to the prohibitive cost, or, if they do, are left in serious debt when compelled to pay for treatment out of pocket. If you have Lipedema or another similar ailment whose treatments have been unfairly denied as cosmetic, you should consult with an expert insurance bad faith attorney to secure the coverage you deserve for the medical treatment you need.
What is Lipedema?
Lipedema is a condition that causes the legs to swell due to excess fat deposits beneath the skin. The disease nearly exclusively affects women, yet it is extremely widespread; according to the National Institute of Health (NIH), it affects about 11% of adult females globally. The symptoms differ from person to person, but they usually feature abnormal body fat accumulation in both legs, stretching from the buttocks to the ankles. While many sufferers have a normal appearance from the waist up in the early stages of Lipedema, the disorder progresses and they may experience similar enlargement of the torso, abdomen, and upper extremities.
Is Lipedema Harmful?
Lipedema is more than just weight increase in specific areas of the body. Lipedema patients cannot simply lose weight by changing their lifestyle or following any drastic weight-loss procedures. In addition, the disease causes easy bruising, sensitivity to touch, and severe pain in all affected extremities. Legs, and later other body parts, expand rapidly in response to hormones or stress, and might finally render the patient disabled. It’s a degenerative, disfiguring, excruciatingly painful, and disabling disease.
Lipedema is a disorder that progresses in phases. Large extrusions of skin and fat tissue emerge on the thighs and around the knees in Stage 3 lipedema, resulting in severe deformations, discomfort, and limited movement. Because a blockage in the lymphatic system prevents lymph fluid from draining properly, stage 4 lipedema is known as lymphedema, producing painful swelling in one or more limbs or legs.
Are There Treatments for Lipedema?
Lipedema can be efficiently managed and mitigated using a variety of therapeutic options. Complete decongestive therapy (CDT), which includes compression garments, bandaging, and manual lymphatic drainage, is one of the known Lymphedema (Stage 4 Lipedema) treatments. The suggested treatment for further phases of Lipedema is specialist suction lipectomy (tumescent liposuction), which removes the unhealthy subcutaneous adipose tissue fat. To control the problem, CDT can be used both before and after liposuction.
Unlike normal cosmetic liposuction, specialist liposuction is recognized to be successful. The method comprises injecting epinephrine and lidocaine into the afflicted area, followed by surgical excision of the damaged subcutaneous fat cells. It utilizes more mild, targeted procedures and removes a smaller amount of fat in the affected areas. The operation is risky, and doctors rarely advocate it; yet, it is known to effectively relieve the pain, disfigurement, and impairment caused by Lipedema.
Why Are Insurance Companies Denying Lipedema Treatments?
Lipedema liposuction can cost tens of thousands of dollars and require many operations. Unfortunately for people with this terrible illness, insurance companies are hesitant to cover the price of any surgery that could be considered “cosmetic,” such as liposuction. Cosmetic procedures are ones that have no further medical value than to improve a patient’s appearance. Many insurance companies have blanket policies that classify all liposuction as cosmetic, refusing to account for people who have legitimate diseases (such as Lipedema) that liposuction can help with.
Does Blue Cross Blue Shield cover liposuction for lipedema?
Liposuction (lipectomy) for the treatment of lipedema will be treated as a non-covered and investigational benefit under Blue Advantage.
Does lipedema fat return after liposuction?
What is surgery’s long-term impact? Is there any information about lipedema patients five to ten years after liposuction surgery? Patients will not have any more diseased fat in their bodies if liposuction surgery is performed properly, and they will be able to resume their usual lifestyles.
Is lipedema an autoimmune disease?
Lipedema, an under-diagnosed autoimmune illness that many people have never heard of, makes it impossible for certain women to lose weight. Cruz was diagnosed with the disease by Dr. Jaime Schwartz, a surgeon in Los Angeles.
According to Dr. Schwartz, who specializes in therapy and awareness, as many as 1 in 9 women may be affected.
âLipedema is not often discussed or diagnosed. Dr. Schwartz explained, âI diagnose doctors with it.â
Lipedema is a connective tissue illness characterized by disproportional big extremities, particularly the hips and legs, due to fat deposits beneath the skin. It is sometimes misdiagnosed as obesity. It nearly entirely affects women who are more adaptable than most and who suffer from flu-like symptoms on a regular basis.
âCara is actually in better shape than I am, and that’s something that a lot of people don’t realize: this isn’t metabolic fat. âThis isn’t about cheeseburgers,â Dr. Schwartz argued.
Lipedema can be treated, but there is no cure for it. Cruz has had liposuction surgery on her lower legs and hips with Dr. Schwartz.
Is lipedema considered a disability?
Lipedema is a chronic, progressive condition that can cause significant disability, impairment in everyday functioning, and psychosocial distress 1, 2. It mostly affects women, and it usually begins between puberty and the third decade of life 3. Lipedema is characterized by aberrant subcutaneous adipose tissue deposition, which results in a bilateral, disproportional volume increase of the lower extremities and, in some cases, the arms. Hands, feet, and trunks are usually spared from fat formation. Lipedema’s pathophysiological mechanisms are still being unraveled. 4. Furthermore, due to a lack of clear diagnostic criteria, determining its incidence is challenging, though it is assumed to be widespread. Lipedema is underdiagnosed by doctors, and it’s frequently mistaken as obesity or lymphedema, two disorders with which it shares key characteristics. Lipedema epidemiology, pathogenesis, clinical presentation, differential diagnosis, and therapy are all topics covered in this study. The overarching goal is to raise physician awareness and progressively provide patients with a diagnosis and appropriate treatment.
Physical and Occupational Therapy / Physical & Rehabilitation Medicine
These practitioners take a hands-on approach to care to build lipedema treatment plans that emphasize exercise, pain management, and improved lymphatic function. Decongestive treatment and manual lymphatic drainage are frequently used by physical and occupational therapists to aid persons with lipedema, particularly those who are at a later stage of the disease. For these treatments, look for qualified lymphatic therapists. Licensed professionals in the field can also assist you in customizing workout routines to meet your goals while taking into account symptoms such as hypermobility. They may also provide assistance with joint problems and recommend functional manual therapy to avoid procedures that injure your fat tissue or fascia layers. If you’re having problems doing the things you need to live and work, you might be assigned to an occupational therapist, who can help you come up with techniques to lessen the impact of lipedema on your everyday life. While a therapist cannot make a medical diagnosis, they are frequently the first to detect lipedema and refer the patient to a physician (usually an MD or DO) for confirmation.
Vascular Medicine
The words “vascular medicine” conjure up pictures of arteries and veins. However, experts in lymphatic vessels can be found in this field of medicine. Lipedema diagnosis and management is a key prerequisite of vascular surgeons’ advanced medical training programs, making them one of the few medical professions where it is. Lipedema versus lymphedema, as well as other disorders, will be carefully differentiated by a vascular medicine specialist. They can assist in making decisions about conservative management and surgery, ensuring that procedures are carried out in a way that causes the least amount of harm to the lymphatic and other vessels. Vascular surgeons may perform some of the procedures or send you to other specialists if surgery is necessary. Other vascular medicine specialists, such as cardiologists, may be consulted at various points along the path to a diagnosis or for the management of problems from other conditions that frequently coexist with lipedema.
Pain Management
Lipedema is characterized by pain. While pain can be addressed by a variety of professionals, in more complicated circumstances, you may be referred to a pain specialist. Physical therapists, as mentioned above, as well as physicians with training in anesthesiology, neurology, and psychiatry, can all be involved in these treatments. Pain management research has advanced significantly in recent years, with numerous data-driven care programs available that limit dependency on surgery and medication. These can range from motivational techniques to dietary and activity modifications. Your pain management specialists should be able to collaborate with you to establish a safe and effective lipedema pain treatment approach.
Plastic and Cosmetic Surgery
A variety of surgical specialties, including plastic and cosmetic surgeons, can undertake lipedema surgery, particularly liposuction. Referral for surgery should follow conservative therapy and be undertaken by a surgeon experienced in lymphatic vasculature preservation techniques, according to international and US guidelines. Referrals to a local practice may not be possible due to the scarcity of surgeons with this training. Be advised that the lipedema reduction technique frequently necessitates many procedures, necessitating multiple visits to the surgeon. Following lipedema liposuction, a referral to a cosmetic or plastic surgeon may be offered to remove any loose skin that remains.
Dermatology
A dermatologist may be consulted in later stages of lipedema or when it occurs in conjunction with other disorders such as lymphedema. These doctors assist in the monitoring of the skin and the prevention or treatment of changes that develop. A dermatologist may provide the first diagnosis of lipedema and even surgical treatment for some persons with Lipedema, particularly those living outside the United States.
Nutritional Health
Many online resources describe lipedema diets or dietary programs, and many people have had success with them. Regrettably, the scientific foundation for these lipedema diets is still mostly theoretical. To date, no big randomized controlled trials have been conducted to determine whether one lipedema diet is superior to another. Even in the absence of good evidence, many patients benefit by experimenting with a variety of diets to identify the ones that work best for them. A qualified dietician can assist you in developing a safe individualized experimental strategy that meets your objectives. They do so by paying close attention to aspects such as your lifestyle and any other ailments you may have, such as food sensitivities, allergies, or health conditions that may be exacerbated by a certain diet. Look for dieticians who are licensed, and be aware that other professionals with similar-sounding names may not be required to be licensed. Most importantly, inquire about their experience with lipedema diets that have been published. If someone advises you to limit calories to an unsafe level, be very cautious. Do they support a single diet or will they assist you in determining which one is best for you? If your dietician is unfamiliar with lipedema, directing them to resources such as our Lipedema Library or other recommendations may be helpful.
Mental Health
Although lipedema is not a mental illness, many persons with the condition benefit from emotional, psychological, and behavioral counseling. More than just talking is what licensed mental health practitioners do. They can be extremely useful in devising techniques to deal with lipedema symptoms such as pain. They can also assist their patients with difficult decisions and behaviors that may arise as a result of treatment or when lipedema interferes with daily life.
How do I get a lipedema diagnosis?
The symptoms and clinical examination are used to diagnose lipedema. Ultrasound, MRI, lymphangiogram, and/or lymphoscintigraphy are among imaging procedures that can be used to diagnose lipedema. Before a diagnosis may be made, other disorders may need to be ruled out.
Does walking help lipedema?
Walking in a pool is one of the simplest workouts to do, yet it has numerous benefits for those with lipedema and lymphedema. The water cools a patient’s legs, promoting blood and lymph fluid movement throughout, in addition to the dynamic compression induced by the density of water. Walking in the water can assist to strengthen the legs while also improving their general shape and tone. The “Nordic walking” technique is a more advanced approach that requires taking a full walking stride in the water while alternating arms and legs as though walking on land.