Cosmetic surgery
Medicare doesn’t cover most cosmetic surgery
Coverage details
Medicare usually doesn’t cover cosmetic surgery unless you need it because of accidental injury or to improve the function of a malformed body part. Medicare covers breast reconstruction if you had a mastectomy because of breast cancer.
Medicare requires prior authorization before you get these hospital outpatient services that are sometimes (but not always) considered cosmetic:
- Blepharoplasty – Surgery on your eyelid to remove “droopy,” fatty, or excess tissue.
- Botulinum toxin injections – Injections used to treat muscle disorders, like spasms and twitches.
- Panniculectomy – Surgery to remove excess skin and tissue from your lower abdomen.
- Rhinoplasty (or “nose job”) – Surgery to change the shape of your nose.
- Vein ablation – Surgery to close off veins.
If your procedure requires prior authorization before Medicare will pay for it, you don’t need to do anything. Your provider will send a prior authorization request and documentation to Medicare for approval before performing the procedure. If Medicare approves your prior authorization request, you should only need to pay your deductible and coinsurance .
Costs
You pay 100% for non-covered services, including most cosmetic surgery.
Ask your doctor or healthcare provider how much your test, item, or service will cost.
Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.
Specific amounts you could owe depend on:
Other insurance you may have
How much your doctor charges
If your doctor accepts assignment
The type of facility
Where you get your test, item, or service