Does Medicare Cover Plastic Surgery?

Victoria Burke by Victoria Burke | Licensed since 2011
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This article was updated on: 09/10/2018

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Plastic vs Cosmetic surgery

Plastic surgery is not the same as cosmetic surgery, according to the American Board of Cosmetic Surgery. Plastic surgery reconstructs facial and body defects due to birth disorders, trauma, burns and disease. Cosmetic surgery aims to enhance appearance by improving symmetry, proportion and aesthetic appeal. Cosmetic surgery and plastic surgery are generally elective surgeries, meaning they are non-emergencies. Plastic surgery may be outpatient surgery, meaning you don’t spend the night the in the hospital, according to the American Society of Plastic Surgeons.

Examples of cosmetic surgeries are:

  • breast augmentation or breast lift
  • rhinoplasty
  • facelift
  • neck lift
  • tummy tuck
  • liposuction and more.

Examples of minimally invasive cosmetic surgeries are:

  • spider vein treatment
  • laser hair removal
  • chemical peels and more

Examples of plastic surgery (also called “reconstructive procedures” by the American Society of Plastic Surgeons) are:

  • scar revision surgery
  • hand surgery
  • breast reconstruction
  • skin cancer removal
  • transfeminine/transmasculine surgery
  • lymphedema treatment
  • burn repair surgery and more

Does Medicare cover plastic surgery?

Original Medicare (Part A and Part B) generally covers plastic surgery in three scenarios:

  • It’s for breast reconstruction if you had a mastectomy because of breast cancer
  • It’s needed because of an accidental injury
  • It’s needed to improve the function of a malformed body part

Examples of plastic surgery Medicare might cover are burn repair surgery or cleft palate surgery.

Medicare may cover plastic surgery on an individual claim basis for other medical issues based on medical necessity. For example, Medicare may cover gender reassignment surgeries for Medicare beneficiaries suffering from gender dysphoria. This may involve plastic surgery on the genitals or breasts.

Does Medicare Advantage cover plastic surgery?

Medicare Advantage is another way to get your Original Medicare benefits through a private insurance company approved by Medicare. A Medicare Advantage plan must cover everything Original Medicare covers, with the exception of hospice care, which is still covered by Part A. A Medicare Advantage plan must cover plastic surgery in all the scenarios that Original Medicare covers plastic surgery. A Medicare Advantage plan may give you additional benefits that Original Medicare doesn’t generally cover.

Do you have more questions about Medicare coverage of plastic surgery or other surgeries?

I can tell you about the various choices you might have for Medicare coverage in your area. If you’d like to connect by phone or have me email you information, just follow the links below. To research plan options on your own at any time it’s convenient for you, click on the Compare Plans buttons on this page.

 

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