The Financial Burden of Living with Lipedema
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Not only does lipedema pose severe physical and mental implications, but the fat deposition disorder also poses a severe economic and financial hardship, negatively impacting one’s ability to find and hold down a job and achieve long-term financial stability, upward economic mobility, and security. And that’s only half of it.
A 2021 study reported by Lipoedema.co.uk found an alarming 73% of those living with lipedema said the condition hindered their ability to work, while 100% stated they had difficulty with clothing, especially finding trousers, undergarments, and footwear (boots) that fitted properly. To add insult to injury, it’s no secret most insurance providers will not cover the costs of surgical interventions to treat/manage the proven debilitating effects of the disease, such as liposuction, manual lipedema extraction (MLE), and lymph sparring, as these procedures are deemed “cosmetic.” Thankfully, more insurance companies are finally considering lipedema surgery as medically necessary and are beginning to approve more and more clients’ coverage costs. Blue Cross and Aetna have recently started accepting coverage for necessary lipedema surgery – but there’s a catch. Patients must first complete a 12-week non-surgical therapy requirement to be considered for lipedema surgery coverage. Patients must carefully document (with images!) every step of the following for qualification, including:
- Healthy dieting journal
- Exercise documentation
- Manual lymphatic drainage sessions
- Compression garments
The High Cost of Having a Chronic Condition
The U. S. medical system and respective insurance providers use the ICD-10 International Classification of Diseases to assign codes to different medical conditions. However, the ICD-10 doesn’t currently have a code exclusive to lipedema treatment, making coverage acquisition especially untenable for most lipedema patients. Since there is no assigned code, lipedema is not recognized as a medical disease by insurance providers. What’s more, insurance providers in the U. S. are skeptical of published research on lymph sparring for lipedema, even though there are several highly-distinguished surgeons who regularly – and successfully – perform the procedure. Their game-changing surgeries continually suggest significant improvement in lipedema symptoms and the quality of life of their patients. Unconvinced by European medical literature in the safety and efficacy of liposuction or lymph sparring, many U. S. insurance companies consider the surgeries “experimental.” Because of the lack of insurance coverage, most patients are subsequently left with a financial burden for the foreseeable future, as they resort to liquidating many if not all, their assets to help pay for their procedure out-of-pocket. This can come in the form of personal banks loans, second mortgages, borrowing money from loved ones, etc. While many lipedema patients are approved for any of the many financing options available through private funding (think CareCredit) companies, there is that additional nut to crack every month that comes with financing a “cosmetic” procedure.
As some insurance companies claim to “work” with patients to obtain coverage, patients should be prepared for months and months of arduous hoop-jumping. Photos, medical records, and letters of medical necessity by board-certified doctors, etc., will be requested to show emphatic proof of the medical need for lipedema surgery. Most human resource specialists have found it tremendously helpful when employees seeking surgery submit written testimonies documenting the hardship the disease has taken on their mental, emotional, psychological, and physical states, including its effect on their daily activities, lifestyle, ability to perform functions, and responsibilities related to their occupation, as well as the impending progression of the disease. Documenting personal experiences offers a raw, emotional element to the patient’s medical journey that simply cannot be understated. It’s especially crucial patients iterate the negative impacts lipedema progression can have on other areas of their health.
Putting “TLC” in Total Lipedema Care
Because lipedema is still a deeply misunderstood and commonly misdiagnosed condition that is still painstakingly trying to gain global awareness and medical recognition, it’s imperative patients become their own advocates for change. While the lipedema community has made admirable strides in its ongoing efforts to build awareness, there is still quite a way to go. Patients seeking lipedema surgery should expect to be fiscally affected on some level when seeking treatment.
Total Lipedema Care understands the need for medical treatment to help effectively manage/mitigate the progression of lipedema and continues to be a leading proponent for standardized insurance coverage for ALL lipedema patients. TLC surgeons and lipedema specialists have been at the forefront of helping lipedema become globally recognized as a certifiable medical condition requiring surgical intervention, but the crusade is a work-in-progress. If you should decide to undergo state-of-the-art treatment for your lipedema with Total Lipedema Care, rest assured we offer complimentary review, submission, and guidance when seeking coverage from your insurance company. We will be with you every step of the way. Contact us today.
To learn more, please contact our Beverly Hills, California office to schedule a consultation with any of our highly trained specialists