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.