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 surgery, an accident 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.
Medicare may cover plastic surgery 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 comsetic surgeries, such as:
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 $1,364 per benefit period in 2019.
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.
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