Lipoedema is a chronic, yet little-understood condition that manifests itself as an abnormal accumulation of painful fat, particularly in the legs, hips or arms. It affects women almost exclusively, and is often accompanied by significant physical and psychological discomfort. At the Clinique du Lipœdème, we see patients every day in search of a precise diagnosis and effective therapeutic support. One question frequently comes up: “Can I benefit from coverage of my treatment?”
If you would like more information on lipoedema, we invite you to consult our articles which may answer your questions: https: //lacliniquedulipoedeme.fr/a-lire/
A disease still awaiting full recognition
Lipedema was officially recognized by the World Health Organization (WHO) in 2021, representing a major step forward. In France, however, this recognition remains incomplete in administrative terms. To date, lipedema has not been included on the list of long-term conditions (ALD), which prevents systematic, coordinated treatment by the French social security system.
However, in-depth work is underway with the French National Authority for Health (HAS), which has launched discussions with several French lipedema experts, including Dr Nicolas Zwillinger. The aim? To draw up an official care pathway, from diagnosis to appropriate treatment, which could lead to structured medical recognition of lipedema in France – an essential condition if we are to hope for more equitable and sustainable care. To date, no official timetable has been given for the completion of this work.
What treatment is currently available?
1. conservative treatments
The first treatments offered to patients suffering from lipedema are conservative:
– Wearing made-to-measure compression garments
– Adapted physical activity
– Lymphatic drainage
– Nutritional follow-up
These treatments can alleviate certain symptoms (pain, sensation of heaviness), without correcting the underlying causes of lipedema. Social security may cover some of these treatments, such as compression stockings, on medical prescription. However, coverage is only partial, and depends on the product code, manufacturer and type of prescription.
2. surgical treatment: liposuction
Today, specialized liposuction for lipedema is considered the gold standard for reducing abnormal volumes and providing lasting pain relief. However, in France, this procedure is still associated with cosmetic surgery, which prevents it from being reimbursed by Social Security.
Unlike other medical procedures, it is not possible to file a request for prior agreement for liposuction in the case of lipedema, as the CCAM (Classification Commune des Actes Médicaux) codes associated with this procedure do not authorize this approach.
Moreover, as lipedema is not officially recognized as a disease in its own right in France, it is not possible for the surgeon performing the operation to issue a post-operative medical leave, as this would be a conflict of interest. However, a physician who diagnoses lipedema, other than the operating surgeon, may prescribe a medical leave of absence before or after the operation, provided he or she recognizes the seriousness of the pathology and its functional repercussions.
What about insurance and mutuals?
Reimbursement still very rare
Traditional mutual insurance companies generally do not cover liposuction for lipedema until the procedure is recognized as medically necessary by the French Social Security system. In the absence of official reimbursement codes, refusals are almost systematic, whatever the mutual insurance company.
Hope for the future in health insurance
However, some top-of-the-range health insurance policies or individual provident contracts agree, on a case-by-case basis, to provide financial assistance for the surgical treatment of lipedema. For this, it is often necessary to compile a complete medical file containing :
– Several medical opinions confirm the diagnosis of severe lipedema
– Documents detailing the impact of the disease on quality of life
– A detailed surgical estimate
These approaches don’t guarantee a positive response, but they can be an avenue for patients to explore.
Steps recommended to patients
Here are the steps to follow to maximize your chances of receiving help or recognition for your illness:
1. Consult a lipedema specialist: For a reliable, documented diagnosis.
2. Compile a documented medical file, including reports, photos, certificates and functional effects of lipedema.
3. Make an appointment with your mutuelle or providence insurance company, with the surgical estimate, to assess the reimbursement margins outside the nomenclature.
4. Contact a GP or specialist in the diagnosis of lipedema to discuss the possibility of medically justified time off work.
5. Contact associations such as AMLF (Association Maladie Lipœdème France), which can provide model letters, testimonials and administrative support.
In conclusion
Financial coverage of lipedema treatment in France remains very limited at present, particularly for surgical treatments that are nonetheless effective. But changing attitudes and ongoing discussions between experts and the French National Authority for Health (HAS) point to a change in the medium term.
In the meantime, the Clinique du Lipœdème, run by Dr Nicolas Zwillinger, continues to welcome and support every patient with listening, expertise and transparency, helping them to navigate the best possible steps to have the seriousness of their pathology recognized.
If you have any questions, we invite you to ask us on our social network Instagram to make it the subject of a future article: https: //www.instagram.com/lacliniquedulipoedeme/
📅 Make an appointment now for a specialized consultation!
https://www.doctolib.fr/chirurgien-plastique/paris/nicolas-zwillinger
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