Does Medicare Cover Plastic Surgery?
Medicare Benefits Solutions
Aug 3, 2020
Are you looking for information on the history of Medicare? Then you’ve come to the right place!
When the Medicare program became law in 1965, it was intended to offer health coverage and some level of financial security for seniors who were locked out of employment-related insurance protection. Since then, the program has undergone some enhancements, including Part C enacted in 1997 and Part D, which was rolled out in 2003.
In recent years, Part C, also known as Medicare Advantage, began offering extra benefits, such as fitness programs, over-the-counter allowances, meal delivery services, transportation to the doctor’s office, virtual telehealth, wheelchair ramps and bathroom grab bars. However, these offerings have not extended to elective surgery.
TIP: Subscribe to the Medicare Benefits newsletter and get more great Medicare-related news delivered directly to your inbox!
Types of Plastic Surgery
Medicare benefits are limited to some types of plastic surgery deemed to be medically necessary, but this typically does not include elective cosmetic surgery procedures. It may be helpful to understand the difference between the two. The purpose of cosmetic plastic surgery is to improve innate features for aesthetic purposes only. Examples are face lifts, liposuction, and body contouring. Medicare would not cover these procedures.
Reconstructive plastic surgery, such as breast reconstruction surgery, is performed to repair body parts impacted by injury, malady, or developmental failings. According to the American Society of Plastic Surgeons, “reconstructive surgery can improve abilities, function and quality of life when structures on the body have been affected by congenital and developmental defects, trauma or disease.”
TIP: Use the Medicare plan finder to help you find more of the benefits you need at a price you can afford.
Plastic Surgery Covered by Medicare
Medicare benefits are available for three specific types of reconstructive plastic surgery.
- One is to remediate an accidental injury, such as skin burns.
- Another is to restore some functionality to a deformed body part. The malformation may be something you were born with, caused by disease, or brought on by aging.
- Also, if you had a mastectomy due to breast cancer and need breast reconstruction, Medicare would cover breast prostheses, known as artificial implants.
TIP: Learn more about Medicare coverage for breast implants.
Find a new Medicare plan
Get recommendations based on what's important to you, and compare them to your existing plan.
Confirm Cosmetic Surgery is Covered
There can be an overlap in surgery intended to enhance beauty and surgery performed to address a medical need. Examples are rhinoplasty and eyelid surgery. In some cases, they are needed to fix a problem that may adversely affect breathing or vision, respectively. However, following the surgery, you may find that your appearance has improved as a byproduct of correcting the issue.
It is a good idea to check with your plan to ensure the type of plastic surgery you need is covered. The cost of any services rendered that are not covered will be your responsibility. For surgical procedures that are eligible for Medicare benefits, be prepared to pay the obligatory deductibles, coinsurance and copayments.
TIP: Check out our 7 reasons to switch Medicare Advantage plans guide.
Call a licensed sales agent at
877-406-1753 or TTY 771
Mon – Sun 5am to 8pm PST
Find a plan
Get plan recommendations
Compare your current Medicare plan to our recommendations – then choose the plan that gives you more of the things you want.