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Does Medicare Cover Cosmetic Surgery?

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By Daniel Petkevich
Nov 28, 2022

Not usually, but there are exceptions

There can be any number of reasons for someone to want cosmetic surgery. For Medicare to cover your plastic surgery, it needs to be deemed medically necessary by your doctor. So generally, Medicare does not offer coverage for cosmetic surgery. But what are the circumstances when Medicare offers coverage? Let's find out.

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How is cosmetic surgery covered by Medicare?

Medicare does not generally offer coverage for cosmetic surgery, but there are specific types of reconstructive plastic surgery that may be partially or fully covered by Medicare. These surgeries are typically related to correcting physical defects caused by congenital anomalies, traumatic injury, or medical conditions such as burns.
In any case, a healthcare professional has to deem the procedure to get Medicare coverage. The cosmetic procedure might be covered by Part A or B depending on whether you are admitted to the hospital or not. Some Medicare Advantage plans may offer extra benefits that could cover some costs related to plastic surgery. Check with your plan provider to see what your plan might offer you.
The exceptions to Medicare's policy on plastic surgery often include reconstructive surgeries that are necessary to improve the functioning of a body part or to correct a deformity related to a birth defect, disease or injury. The surgery must not only improve the person’s appearance, but also improve their quality of life.

How can you pay for cosmetic surgery without Medicare coverage?

If you are looking to have cosmetic surgery and Medicare does not cover it, then you may have to pay for the procedure out-of-pocket. However, many plastic surgeons offer financing options such as payment plans or low-interest loans in order to help patients pay for the procedure. Additionally, some insurance companies may cover certain cosmetic procedures, so you can check with your provider to see if they offer any coverage. You could also consider a medical savings plan or use a credit card to pay for the procedure.

How do you know if cosmetic surgery is right for you?

Cosmetic surgery can be a great way to boost your confidence and improve your physical appearance, but it’s important to make sure it’s the right choice for you.

Risks of getting cosmetic surgery done

The involved risks include complications, reactions to anesthesia and infections. Before you make a decision, it’s important to discuss the procedure with your doctor and evaluate all the potential risks.
It’s also important to have realistic expectations and be aware that results may not be exactly as you had hoped.

Takeaway

Medicare does not generally cover cosmetic surgery, but there are exceptions for reconstructive surgeries that are medically necessary. If you are considering having cosmetic surgery, it’s important to discuss the procedure with your doctor and evaluate all the potential risks. This content is for informational purposes only. For any Medicare-related questions, give us a call today to speak with an expert.

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Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

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Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2022 Help Button Inc

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