Does Insurance Cover Liposuction For Lipedema?

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. In order to deny coverage, insurance companies incorrectly describe Lipedema treatments as “cosmetic.” If you have Lipedema or any similar ailment for which treatment is being rejected because it is considered aesthetic, you should consult with an expert insurance bad faith lawyer to secure the coverage you deserve for the medical treatment you require.

What is Lipedema?

Lipedema is a condition that causes the legs to swell due to excess fat accumulation 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 victims have a normal appearance from the waist up in the early stages of Lipedema, the illness progresses and they may have 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 insurance pay for lipedema liposuction?

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. Lipedema surgery is usually covered by most insurance carriers.

How do I get lipedema covered by insurance?

: You must undergo a functional capability assessment (FCE; also known as a functional assessment of disability). There must be a medical reason for your lipedema surgery to be covered by insurance. This could be due to the presence of swelling, pain, or issues with mobility and other daily tasks. A FCE can assist you exhibit problems with sitting, standing, carrying, bending, and other activities. This assessment can only be completed by trained Physical Therapists (PT) or Occupational Therapists (OT). Because not all physical therapists and occupational therapists have been trained, you may need to contact various 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.

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?

VASER reduces the size of your legs and other affected areas dramatically. Your VASER treatment will produce rapid results: your lipedema fat will be noticeably decreased! There will be some swelling and soreness/pain in the treated area, but this will subside during the first week to ten days of recovery. As your body adjusts to its new contours, swelling will continue to reduce. Patients usually notice the final effects of their VASER liposuction within six months to a year, but there may be swelling for several months following surgery for lipedema in the thighs or legs, and total recovery might take up to 18 months. The pain relief provided by the procedure is well worth the recovery time. As you heal, you will notice that the pain and discomfort you were experiencing previous to your operation are no longer there! Patients report that their smaller contours boost their confidence and make them feel more appealing.

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.


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.

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.

Who is the best lipedema surgeon?

Yes, there is a ray of hope! Lipedema, commonly known as lipoedema, is a disorder that is frequently misunderstood. It is estimated that up to 11% of women have it, with 17 million women in the United States and 370 million women worldwide impacted. Lipedema is a painful and debilitating condition in which pathologic fat collects in the legs and limbs.

Dr. Granzow is a well-known surgeon around the world. He created the Lipisuction technique to treat the pain and obesity associated with lipedema in a safe and effective manner.

What is the best diet for lipedema?

Because lipedema is mostly caused by a woman’s lymphatic system, some foods can have a negative impact on her health. Lipedema symptoms can be exacerbated by highly processed foods or refined sugar, to name a few culprits. While everyday circumstances and treatment options differ by patient, some women find that following certain dietary plans, such as the RAD diet for lipedema, helps them lose weight. The RAD (Rare Adipose Disorder) diet tries to keep women at their ideal weight by reducing inflammation and fluid retention in the body. The RAD diet for lipedema involves cutting back on the following foods:

Sugars and simple carbs (potatoes, honey, white rice, pasta, or cereals)

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.