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Medicare does not typically cover elective plastic surgery. Medicare may, however, cover cosmetic surgery if it’s needed due to an injury, surgery or a physical defect.
Original Medicare (Part A and Part B) typically does not typically cover plastic surgery. In some limited circumstances, Medicare may cover cosmetic surgery due to an accident, as part of another surgical treatment or to improve a malformed body part.
Medicare Advantage (Part C) plans may cover plastic surgery, if the surgery would otherwise be covered under Original Medicare.
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Medicare may cover a plastic surgeon if it is a reconstructive procedure performed on an area of the body that is malformed or damaged due to injury or an operation. The goal of the cosmetic surgery is to restore a normal appearance and/or function.
Plastic surgery is typically only covered by Medicare if it is for an approved condition, such as:
Medicare does not provide any coverage for selective plastic surgery. You will have to pay 100% of the costs out of pocket for selective cosmetic surgeries, such as:
Medicare may cover rhinoplasty if your doctor or provider gets prior authorization from Medicare for the procedure.
Even if Medicare covers your plastic surgery, there are some out-of-pocket costs you should expect to pay, depending on where you receive your surgery.
The Medicare Part A deductible is $1,632 per benefit period in 2024.
The Part A deductible is not annual, and you could experience more than one benefit period in a given calendar year.
After you meet your Part A deductible in a benefit period, you could face Part A coinsurance costs for an inpatient hospital stay that lasts longer than 60 days (which is not common for most plastic surgeries).
There is no annual limit on how much you could pay for the Part B coinsurance in a given year.
We recommend speaking with your doctor directly for specific cost and coverage information.
Medicare Advantage plans are required to cover the same benefits that Original Medicare covers.
If your plastic surgery, such as breast prostheses implantation, is covered by Original Medicare, it will also be covered by a Medicare Advantage plan.
A licensed insurance agent can help you compare Medicare Advantage plans that are available where you live. Some plans may be able to help pay for your Medicare-covered plastic surgery costs.
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
..Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
By clicking "Sign me up!” you are agreeing to receive emails from MedicareAdvantage.com.
Your Medicare guide will arrive in your email inbox shortly. You can also look forward to informative email updates about Medicare and Medicare Advantage.
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