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 prostheses for breast reconstruction if you had a mastectomy because of breast cancer.
You pay 100% for non-covered services, including most cosmetic surgery.
Medicare requires prior authorization before you get these hospital outpatient services that are sometimes considered cosmetic:
- Blepharoplasty – Surgery on your eyelid to remove “droopy,” fatty, or excess tissue.
- Botulinum toxin injections (or “Botox”) – 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.
Some Medicare Advantage Plans (Part C) offer extra benefits that Original Medicare doesn’t cover - like vision, hearing, or dental. Contact the plan for more information.