The issue of cost coverage for lipoedema is of great importance to many sufferers. For years, liposuction was a self-pay service for most sufferers, especially in stages 1 and 2. With the GBA decision of July 17, 2025, the prospect of cost coverage by health insurance companies for an extended group of patients was made possible under certain conditions. But what does this mean in concrete terms? Who can benefit from cost coverage and what hurdles still exist?
We at LipoClinic Dr. Heck would like to give you an overview, take away your uncertainties and at the same time show you what options you have as a patient.
Many women have been fighting for years for lipoedema to be recognized and for the costs of liposuction to be covered by health insurance companies. The decision of the Federal Joint Committee ( GBA ) on July 17, 2025, according to which health insurance companies could soon cover lipoedema surgery as a health insurance benefit under certain conditions, initially caused great joy among all those affected – a very important step for us too, as we have been doing educational work as a specialized clinic for lipoedema for over 10 years. However, a closer look at the conditions for such cost coverage triggers numerous questions, which we would like to clarify for you below.
In order for liposuction to be covered by health insurance, several conditions apply:
These regulations are intended to ensure that liposuction is medically justified – but mean that patients who have already received their diagnosis from another specialist have to start from scratch and patients with a BMI >35 kg/m² are excluded from cost coverage. This can not only be time-consuming for many patients, but also a psychological challenge.
The aim of the GBA decision is to make lipoedema treatment more accessible for those affected. On closer inspection, however, the reality is much more complex:
The limited choice of specialists who are allowed to make a lipoedema diagnosis recognized by the health insurance funds is a major challenge. How long did you wait for your diagnosis or the long-awaited appointment with a specialist? It is not uncommon for the diagnosis to fail due to the doctors’ lack of knowledge and for lipoedema not to be correctly diagnosed for years. In addition to the lack of knowledge, you can also expect long waiting times, as the group of diagnosticians in Germany is very small. This problem also affects women who have already received a lipoedema diagnosis from a private doctor. This does not count towards health insurance coverage, so a new diagnosis by one of the licensed specialists is necessary. This further delays the already long journey to a pain-free life.
But this is not the end of the bureaucratic process. According to the so-called four-eyes principle, in addition to the diagnosis by a licensed doctor, the surgeon must also provide an indication, i.e. the official justification for the procedure. Both steps must be carried out at least six months apart, during which conservative therapy (compression, exercise, lymphatic drainage) must be continued. In addition, there must be no weight gain during this time – otherwise there is a risk of loss of approval for cost coverage by the insurance company.
Not every doctor is allowed to operate on lipoedema at health insurance costs. Those who have already performed liposuctions in the past must provide evidence of at least 50 operations. New surgeons only need 20 operations within two years.
Liposuction for lipoedema differs fundamentally from aesthetic procedures in terms of technique and objectives. Expertise and routine are crucial for a safe and lasting result – especially with this complex disease.
Realistically, only a small proportion of affected patients will benefit from liposuction as a statutory health insurance benefit. In Germany, it is estimated that around 2.6 million women are affected by lipoedema. At the same time, there are probably only around 50 clinics that are allowed to offer this operation at health insurance costs. This theoretically corresponds to over 50,000 patients per clinic – a mathematical overload that will lead to enormous waiting times.
As a specialized private clinic, we operate independently of health insurance regulations. This means
Our experience shows that patients appreciate the clear procedure, the personal care and the high quality standards – precisely because the financing of lipoedema surgery by a health insurance company is associated with so many uncertainties. You will receive an invoice from us for your individual treatment contract.
The financing of liposuction is an emotional and complex issue. The current decision situation creates hope, but also leads to uncertainty. It is important that you inform yourself well and make your decision independently of external constraints.
The team at LipoClinic Dr. Heck will support you – with empathy, expertise and a clear promise: We are at your side, from the first consultation to your new attitude to life.
Do you have questions about cost coverage or would you like to find out about financing options? Arrange a non-binding consultation now – we will take the time for you.
No. LipoClinic Dr. Heck is a private clinic and is not licensed by health insurance companies. We are therefore unable to bill health insurance companies directly. You will receive an invoice from us for your individual treatment contract.
Yes, we can diagnose lipedema as part of our consultation and treat you as usual. However, we no longer issue a diagnosis that is recognized by health insurance companies. An exception only applies to international patients or privately insured patients. The Federal Joint Committee (GBA) has stipulated that a diagnosis valid for health insurance companies may only be made by certain specialists.
Each case is individual. We expect a relatively high demand for cost coverage from health insurance companies. The number of approved doctors and clinics is very limited, but demand is high. Long waiting times may be expected.
As a private lipoedema clinic, we are not affected by the conditions of the court rulingBA decision. There are only a few exclusion criteria for an operation, such as a maximum weight of approx. 130 kg or certain pre-existing conditions. We will be happy to discuss these points with you individually – either by telephone or preferably during a free personal consultation on site.
After a personal consultation, the operation can usually take place within a few weeks, provided your medical history and all preparatory criteria such as flat knit and blood count are met.
Our treatments are provided on the basis of a hospital admission contract, which includes medical treatment, accommodation, meals and nursing care.
This means that we agree fixed flat-rate prices with our patients. This approach was confirmed by the Federal Court of Justice (BGH) in June 2024. The decisive factor here is that our procedures are inpatient treatments – and in these cases, private clinics are not bound by the German Medical Fee Schedule (GoÄ).
For you, this means that you receive full transparency about the costs right from the start and can rest assured that you will not incur any additional fees.
Naturally. You will receive the cell phone number of your surgeon, who will accompany you from the beginning to the end of your journey. A special follow-up appointment is always scheduled after one year.
We will issue you with a certificate of incapacity for work for two weeks after the operation so that you can regenerate optimally.
We also offer tightening via LipoSthetic, but only at our Mülheim an der Ruhr location.
G-BA: Surgical treatment of lipedema: G-BA includes liposuction in the regular benefits catalog after positive benefit assessment. (https://www.g-ba.de/presse/pressemitteilungen-meldungen/1274/)
LipoCheck: Your checklist for the liposuction application for lipoedema to the health insurance company. (https://www.lipocheck.de/magazin/checkliste-liposuktion-lipoedem-antrag-krankenkasse-7edac)
Dr. Thomas Witte is Medical Director of LipoClinic Dr. Heck and a specialist in plastic and aesthetic surgery. With decades of surgical experience and a deep understanding of the individual needs of lipoedema patients, he is one of the leading experts in this field. His focus is on holistic, safe and empathetic care – always with the aim of restoring quality of life.
Medical Director
Specialist in plastic and aesthetic surgery
Specialist in surgery and hand surgeon
