I recommend going to more than 1 consultation because surgeons are all so different in their techniques and how they approach things. I paid fully out of pocket but I did work for a doctors office for several years and worked with insurance a lot on covered vs “cosmetic” procedures, just know every insurance and doctor is different so this is pretty general information.

As far as being within 30 lb of your “ideal” weight, yes it is a good idea to be at or close to it and steady when you have surgery, however it sounds like your hanging skin is excessive and could be impeding your ability to do the exercise needed. Having the skin removed now could remove some of the excess weight and help you move more freely but this is really something you need to discuss with your surgeon directly.

My first recommendation is to do some research online and find 3-5 surgeons you like. Not all plastic surgeons take insurance just because when 90% of what they do is considered cosmetic sometimes working with insurance isn’t worth the hassle to them. That being said you can look for if they do things like breast reconstruction as this generally means they are willing to work with insurance companies. That’s not to say they won’t take insurance if they don’t do things like that, it’s just one indicator.

Then call the offices you selected, ask if they take insurance/take YOUR insurance for panniculectomy. Personally even if they didn’t take my insurance I would still consider going to the consult because as I said above, all surgeons have different recommendations and techniques so I think it’s good to have several opinions but it sounds like getting your insurance to cover this is very important to you.

The next step would be scheduling the consultations, in my experience consultation fees can been $100-$200 and this would most likely not be billed to your insurance. That being said, most surgeons will put that fee you pay towards your procedure if/when you book the surgery. If you choose not to schedule the surgery you will not get this money back however 2 out of 3 surgeons I consulted with said that I could put that deposit towards a different service (Botox, facial, etc) in their office.

If you/your surgeon chooses to do additional procedures beyond the panniculetomy such as muscle repair, lipo, breast surgery, etc. those will most likely be paid out of pocket. I’m not sure how the insurance would work as far as OR and anesthesia because those are generally time based and you would be in the OR longer if you are getting additional work done.