In short: usually not. Most health insurance plans consider cosmetic surgery elective (for appearance only), so they won’t pay for purely aesthetic procedures. Insurance focuses on medical necessity – surgeries that treat injuries, congenital problems, or serious symptoms. If a procedure is only to improve looks, you generally pay out of pocket.

Medical vs. Cosmetic Procedures

Health plans cover health-related surgeries, not vanity procedures. For example, Aetna’s policy states that cosmetic surgeries are excluded unless they’re needed to improve the function of a body part. In other words, fixing breathing or vision issues might be covered even if the procedure is cosmetic-looking. Medicare makes the same point: it “doesn’t cover most cosmetic surgery” unless it corrects a deformity or injury. For instance, Medicare will pay for breast reconstruction after a mastectomy (cancer surgery) but not for breast augmentation done for beauty. The bottom line: if the surgery fixes a health problem or injury, insurance may chip in; if it’s “just for looks,” it’s usually not covered.

Procedures Sometimes Covered

Some cosmetic surgeries can be covered when there’s a medical reason. Examples include:

• Breast reduction: Often covered when needed to relieve chronic pain (back, neck, shoulder) caused by overly large breasts. Many plans will pay for part of breast reduction surgery because it improves health and comfort, not just appearance.

• Eyelid surgery (Blepharoplasty): Covered if droopy eyelids are blocking vision. Dr. Kimberly Henry explains that many insurers will approve eyelid lifts when they’re done to improve sight, even though they look cosmetic.

• Rhinoplasty (nose job): Covered if it fixes a medical issue like a deviated septum or breathing problem. Nose reshaping purely for looks is cosmetic, but if it corrects structural issues, insurance often treats it as reconstructive.

• Skin removal (Panniculectomy): May be covered after major weight loss if excess skin causes rashes, infections, or mobility issues. Medicare, for example, notes that removing excess belly skin can be covered when it’s a medical necessity (not just to tighten the tummy).

• Reconstructive surgery after trauma: If you’ve had an accident, cancer, or birth defect, insurance usually covers the surgery needed to “fix” the damage. For example, facial reconstruction after a car crash or scar revision for disfigurement is treated as medically necessary. Medicare explicitly covers things like breast reconstruction after a mastectomy because it restores normal form and function.

• Otoplasty (ear pinning): Rarely covered, unless it’s done to correct a deformity that impairs hearing. In general, surgeons report that ear surgeries for purely cosmetic pinning are not approved by insurers, but if a child has hearing issues from malformed ears, it might be covered.

Each of these exceptions comes with conditions. Your insurance will require proof (doctors’ notes, photos, test results) that the surgery is medically necessary. Even if a procedure can be covered, you’ll need prior authorization from the insurer. Always confirm with your plan before surgery.

Common Cosmetic Procedures (Not Covered)

On the flip side, purely cosmetic surgeries are almost never covered. Procedures like liposuction, face-lifts, Botox, hair transplants, and elective breast augmentations are generally excluded. As one industry guide puts it, “most health insurance does not cover cosmetic surgery or its complications”. For example, Aetna and other insurers list liposuction and rhytidectomy (face-lifts) as cosmetic – they fall under exclusions. Even nose jobs for shape (rhinoplasty) are off-limits unless there’s a breathing issue. In short, any surgery done only to improve appearance – with no medical problem behind it – is your responsibility to pay.

How to Check Your Coverage

If you’re considering surgery, talk to your insurance company and your doctor early. Before scheduling, ask for a pre-authorization or pre-certification. Many insurers (including Medicare) require documentation and approval first. Ask your surgeon to provide medical records and test results showing why the surgery is needed. When you contact your insurer, describe exactly what procedure it is and why. Check if they have specific rules (e.g. a minimum amount of tissue to remove for breast reduction).

Keep in mind that even with approval, you’ll still pay deductibles and co-pays. For example, Medicare says you pay 100% for non-covered cosmetic services, and for covered services you still owe deductibles. So get a cost estimate and understand your out-of-pocket. It may help to get quotes or ask about payment plans for the cosmetic part of the surgery if it’s only partly covered.

Conclusion:

In summary, health insurance rarely pays for cosmetic surgery unless it’s treating a medical issue. Elective cosmetic procedures (for beauty or vanity) are generally excluded by plans. However, there are important exceptions: surgeries to correct medical problems, injuries, or defects can be covered at least partially. Always review your policy details or call your insurer. As Dr. Henry, a board-certified surgeon, advises, “speak with a representative of your insurance company before pursuing surgery… you might find that insurance may provide some economic relief” for medically-necessary cases. Ultimately, carefully document the medical need and stay in contact with your insurer – that’s the best way to know what’s covered.