Key takeaways

  • Medicare does not cover cosmetic plastic surgery. It primarily covers medically essential plastic surgery to treat trauma, malformations, or breast reconstruction after mastectomy.
  • Plastic surgery, including reconstructive surgery, is intended to improve the body’s appearance and function, while cosmetic surgery mainly enhances aesthetic appearance.
  • Original Medicare covers plastic surgeon services for medically necessary procedures, with Part B covering outpatient procedures and Part A covering inpatient hospitalization.

Plastic surgery is a billion-dollar industry. If you’re a Medicare beneficiary, you may wonder if Medicare covers certain plastic surgery procedures.

While Medicare does not cover all plastic surgery procedures, it does cover medically necessary plastic surgery procedures. This rule is not likely to change anytime soon, even as Medicare legislation changes in the future.

In this article, we explore Medicare’s plastic surgery rules, including what is covered, what is not covered, and what out-of-pocket expenses you can expect for these procedures.

Plastic vs. cosmetic surgeons

Plastic surgery and cosmetic surgery are often used interchangeably. However, there are some fundamental differences between the two types of surgeries.

Plastic surgery is intended to improve the body’s appearance and function. This includes reconstructive surgery, for example, in which the doctor addresses damage caused by things like illness, congenital defects, or trauma. On the other hand, cosmetic surgery is mainly aimed at enhancing aesthetic appearance.

Plastic surgeons are certified by the American Board of Plastic Surgery (ABPS), the only medical board recognized by the American Board of Medical Specialties (ABMS).

Conversely, cosmetic surgeons may be certified by the American Board of Cosmetic Surgery (ABCS) or other specialty boards. However, these are not recognized by the ABMS or accredited with certifying doctors to perform plastic surgery.

Both plastic and cosmetic surgeons may do cosmetic procedures. However, board certified plastic surgeons only perform surgery in accredited or licensed facilities.

Learn more: The differences between plastic and cosmetic surgery.

Medicare considers medically necessary plastic surgery procedures to be those that are needed because of injury, malformation, or reconstructive surgery after breast cancer surgery.

If you are enrolled in Medicare, these are the situations when Medicare will cover your plastic surgery:

On the other hand, cosmetic surgery performed for appearance only, and therefore not considered medically necessary, is not covered under Medicare. Examples of purely cosmetic surgery include tummy tuck, breast lift, or breast augmentation not related to a mastectomy.

That said, some medically necessary plastic surgery procedures may also qualify as cosmetic surgery procedures. For example, excess eye skin removal to fix vision problems may improve the look of the eyelid. However, this is still different from a surgery performed purely for cosmetic reasons.

Some plastic surgery procedures, such as rhinoplasty, are done in an outpatient clinic. This means you can return home the same day as the surgery, and they would be covered under Original Medicare’s Part B.

Other medically necessary plastic surgery procedures, such as upper or lower limb surgery, for example, are inpatient procedures covered under Part A because they require overnight hospitalization.

Does Medicare pay for a plastic surgeon?

Original Medicare will cover the services of a plastic surgeon if they perform a medically necessary procedure. If you undergo an outpatient procedure, the cost will be covered by Part B. If you have to be hospitalized, the cost will be covered by Part A.

Does Medicare Advantage cover plastic surgery?

You have the option of signing up for Medicare Advantage (Part C), which is an alternative to Original Medicare (parts A and B). This is a private plan that has to offer the same coverage as Original Medicare.

In addition, some Part C plans may cover plastic surgery under additional indications and purely cosmetic surgical procedures.

Depending on your coverage, whether you require inpatient or outpatient surgery, here are some out-of-pocket costs you may encounter.

Medicare Part A

If you’ve been admitted to a hospital for injury or trauma and require plastic surgery, Medicare Part A covers your hospital stay and any inpatient procedures.

You will owe a deductible for each benefit period. For 2025, that amount is $1,676. If you are admitted for a period of 60 days or less, you will not owe any coinsurance. If you are admitted for 61 days or longer, you will owe a coinsurance amount that depends on your length of stay.

Medicare Part B

If you undergo plastic surgery in an outpatient setting, Medicare Part B covers these medically necessary procedures.

In 2025, you will owe a deductible of $257 if you haven’t already paid it for the year. After you’ve met your deductible, you will be responsible for 20% of the Medicare-approved amount for the procedure.

Medicare Part C

Medicare Advantage (Part C) plans are managed by private insurers. Your deductible, premium, and copay or coinsurance depend on your specific plan.

According to the Centers for Medicaid & Medicare (CMS), the average monthly premium for Part C plans is around $17.00 in 2025.

If you require reconstructive plastic surgery, your Original Medicare or Medicare Advantage will cover your procedure.

Plastic surgery procedures that are covered under Medicare plans include repairing damage from injury or trauma, improving the functionality of a malformed body part, and breast reconstruction after breast cancer surgery.

Original Medicare and Medicare Advantage plans have their own plan costs. So, talking with your doctor about your potential out-of-pocket costs for these procedures is always an important step.