Cosmetic surgery
Medicare Coverage Information
Overview
Medicare generally does not cover cosmetic surgery performed solely for aesthetic reasons. However, Medicare may cover reconstructive surgeries that are medically necessary to improve bodily function or correct significant deformities resulting from injury, disease, or congenital defects.
- Cosmetic procedures purely for appearance are not covered by Medicare
- Reconstructive surgeries may be covered if medically necessary
- Must be performed by Medicare-approved healthcare providers
- Requires documentation proving medical necessity from a physician
- Coverage varies between Original Medicare and Medicare Advantage plans
- Medicare Part B beneficiaries
- Patients with documented medical conditions requiring reconstructive intervention
- Procedures must be performed by Medicare-participating providers
- Patients responsible for full cost of elective cosmetic procedures
- Medically necessary reconstructive surgeries typically covered at 80% after meeting Part B deductible
- Potential additional out-of-pocket costs depending on specific procedure and plan
- No coverage for purely aesthetic enhancements
- Requires extensive medical documentation
- Must be deemed medically necessary by Medicare standards
- Pre-authorization may be required for complex reconstructive procedures
- Consult with your healthcare provider about medical necessity
- Get detailed documentation supporting the medical need for the procedure
- Contact Medicare directly to confirm coverage specifics
- Review your specific Medicare plan's coverage details
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare cosmetic surgeryMedicare plastic surgerymedically necessary proceduresMedicare coverage rulesreconstructive surgery
Related Coverage Topics
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