Does Medicare Cover Cosmetic or Reconstructive Surgery?

picture of an older woman with marks for cosmetic surgery with gloved hands holding her face with article title written next to her

It’s no secret that cosmetic surgery is popular in this country – and it’s been increasing in popularity with older adults in particular. Understandably, many older adults want to look good and feel good about themselves. Which is probably why Americans aged 55 and up accounted for nearly 4.2 million cosmetic procedures in 2020. And because most of the seniors getting this type of surgery are within Medicare age, the question is will Medicare cover any of these cosmetic surgeries? The answer to that question is generally no but is dependent on a few factors.picture of an older woman with marks for cosmetic surgery with gloved hands holding her face with article title written next to her

Medicare & Cosmetic Surgery

As we said, Medicare usually will not cover cosmetic surgery. But there are some exceptions: if the surgery will improve the function of deformities or abnormal body parts, or it is considered a reconstructive surgery, you might be able to get coverage. 

 

illustration of a penguin in doctor's scrubs and a scalpal Medicare may cover the following surgeries with prior authorization:

  • Blepharoplasty – Eyelid surgery that Medicare might cover if it could functionally improve your vision. This can include the removal of droopy, fatty eyelids.
  • Botox – Medicare might cover this neurotoxin injection for the treatment of chronic migraines in adult patients, but botox to specifically treat skin wrinkles is not covered by Medicare.
  • Panniculectomy -Surgery to remove excess skin and tissue from your lower abdomen. Medicare does not cover panniculectomy for cosmetic purposes.
  • Rhinoplasty – Nasal surgery that Medicare might cover to improve nasal respiratory function. For example, they will cover it if it improves a nasal airway obstruction.
  • Vein ablation – The treatment of varicose veins of the lower extremities. Spider veins are most often treated for cosmetic purposes. So Medicare usually won’t cover vein ablation but can be in rare instances.

Medicare & Reconstructive Surgery

If you need reconstructive surgery due to one of the conditions above, or some other injury or disease, Medicare might cover it. Outpatient cosmetic services covered by Medicare Part B require prior authorization. And if medically approved, you will only have to meet your deductible and pay your 20% coinsurance.

Need Help?

If you do need reconstructive surgery, that 20% coinsurance might seem a bit daunting, but there is help available. A Medicare Supplement Plan can help cover the out-of-pocket costs that Original Medicare does not cover. There are 10 different Medicare Supplement Plans to choose from, each offering different coverage options and rates. It’s worth looking into a Medicare Supplement Plan to save as much money as you can. So speak to an EZ agent for all of your options. EZ’s agents work with the top-rated insurance companies in the nation and can compare plans in minutes for you at no cost. To get free instant quotes for plans that cover your current doctors, simply enter your zip code in the bar on the side, or to speak to a licensed agent, call 888-753-7207.

About The Author:
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Cassandra Love
With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.

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