I had both Medicare Advantage Plan through AARP and Medicaid approval for skin reduction from my thighs. It was *not* a lift, simply removal of excess skin. They *will not* pay for lifts unless medically necessary.
Excision will most likely be approved if it's causing problems, like infection, rashes and skin erosion. I was getting cellulitis infections every other month once I lost weight (257 pounds). It got so bad that the last round had to use two different antibiotics to knock it down, which meant it was getting to be antibiotic resistant. I had documentation from my doctor and myself. Make sure you have a good detailed letter written. In my case, my doctor had me to draft a letter, she reworked it and added dates of treatment for the infections and sent it in with her documentation.
Choose your words carefully. Excision, which involves no cosmetic lifting, just removal of skin, is most likely to be approved, especially if it is contributing to or causing other health issues.
I've heard of some WLS patients who lucked out and got a surgeon who threw in the lift part just because. Not likely, but worth hoping for. Just don't get depressed if it doesn't happen.
My upper body, arms and breasts, will be on me, since they are not currently causing any medical issues. Some surgeons also have an age limit for certain procedures.