Health insurance & lipedema: What you should know
Since 2020, statutory health insurance companies in Germany have been able to cover the costs of liposuction for lipedema under certain conditions. This regulation applies exclusively to patients in stage 3 with a body mass index (BMI) below 35. The conditions for reimbursement are clearly defined:
- Conservative therapy (e.g. compression, lymphatic drainage) must have been carried out for at least six months without noticeable improvement.
- There must be a clear medical need, such as severe pain or significant restrictions in movement.
- No more than 3,000 milliliters of fat may be removed per operation.
Health insurance coverage at the LipoZentrum is difficult
As a private clinic without statutory health insurance approval, statutory health insurance providers can only cover the costs of treatment at our facility in exceptional cases. Most insurance companies reject such applications – even if all medical requirements are met.
Nevertheless, we support our patients to the best of our ability when applying for reimbursement. This includes, among other things, medical opinions, careful documentation, and instructions on how to submit a correct application.
If the application is rejected, there is the option to file an appeal and, if necessary, to sue. Unfortunately, the chances of success are limited. Nevertheless, we recommend not shying away from legal action: Only if many affected people fight back can long-term change in the healthcare system take place. The more voices are raised, the greater the social and political pressure to finally provide lipedema patients with the support they deserve.
