Cosmetic Surgery and Procedures

Aetna excludes cosmetic surgery/procedures as not medically necessary but will cover specific procedures—blepharoplasty (CPB 0084), breast reduction (CPB 0017 or CPB 0615 for gender-affirming), chemical peels and dermabrasion (CPB 0251), and collagen implants only for urinary incontinence (CPB 0223)—provided the referenced CPB medical-necessity criteria are met. The policy explicitly excludes a long list of cosmetic procedures (e.g., breast augmentation, mastopexy, labiaplasty/vaginal rejuvenation, buttock augmentation, facial fillers except for HIV-related facial lipoatrophy, tattoo removal, Kybella/Daxxify/Qwo, earlobe repair without trauma) and deems removal of injected silicone for autoimmune prevention/treatment experimental and not covered.

"Eye (ocular) prostheses and surgical implantation/attachment - considered medically necessary when prosthesis criteria in CPB 0619 - Eye Prosthesis are met."