Cosmetic surgery

Medicare usually doesn’t cover cosmetic surgery unless you need it because of accidental injury or to improve the function of a malformed body part. Medicare covers breast reconstruction if you had a mastectomy because of breast cancer.

Medicare requires prior authorization before you get these hospital outpatient services that are sometimes (but not always) considered cosmetic:

• Blepharoplasty – Surgery on your eyelid to remove “droopy,” fatty, or excess tissue.
• Botulinum toxin injections – Injections used to treat muscle disorders, like spasms and twitches.
• Panniculectomy – Surgery to remove excess skin and tissue from your lower abdomen.
• Rhinoplasty (or “nose job”) – Surgery to change the shape of your nose.
• Vein ablation – Surgery to close off veins.

If your procedure requires prior authorization before Medicare will pay for it, you don’t need to do anything. Your provider will send a prior authorization request and documentation to Medicare for approval before performing the procedure. If Medicare approves your prior authorization request, you should only need to pay your deductible and coinsurance .