Short answer: often yes, when the scar is causing a medical problem. Health plans generally cover scar revision and keloid treatment when the scar came from an injury, burn, surgery, or disease and it causes functional impairment (such as a contracture that limits movement), significant symptoms like pain or itching that did not respond to conservative care, or an unstable scar that bleeds, breaks down, or keeps getting infected. Revision done only to improve appearance is usually excluded. California is an important exception: state law also treats surgery that creates “a normal appearance, to the extent possible” after trauma, surgery, or disease as reconstructive, which can open coverage for disfiguring scars on fully insured California plans and Medi-Cal.
This page explains how the major insurers decide, what documentation they want, which treatments they usually pay for, and how to prepare your case. It reflects published payer policies reviewed in October 2026. Your own plan documents always control, so confirm your benefits before treatment.
Every insurer sorts scar procedures into two buckets:
Most national commercial policies also state that emotional distress or self-consciousness on its own does not make a procedure reconstructive. That is why careful documentation of physical symptoms and function is so important.
These are the complaints that most often bring patients in, and the ones that most often support coverage:
Although every policy is worded differently, approvals usually come down to these points:
The table summarizes publicly posted medical policies. Plans vary, and your evidence of coverage or summary plan description overrides these general policies.
| Insurer (policy) | What is usually covered | Key requirements and limits |
|---|---|---|
| Aetna (CPB 0031, 0389, 0551) | Keloid repair causing pain or functional limitation; revision of surgical scars causing symptoms or impairment; steroid or 5-FU injections and cryotherapy for qualifying keloids; radiation after keloid excision | Radiation must begin within 7 days of excision. Fractional ablative laser only for burn, traumatic, or surgical scars with limited movement after failed tape or silicone. Fillers, acne scar treatment, PRP, and microneedling for scars are excluded. |
| Cigna (Coverage Policy 0328, Scar Revision) | Laser treatment and 5-FU injections for trauma or surgical scars causing functional impairment | Initial laser course up to 6 sessions, then objective proof of improvement. Dermabrasion, peels, fillers, fat transfer, and Botox for scars are not covered. Coverage also depends on plan language. |
| UnitedHealthcare (Cosmetic and Reconstructive Procedures) | Procedures that correct a documented functional impairment with a proven treatment | Psychological impact alone does not qualify. Tissue rearrangement (Z-plasty and similar) requires review. Many plans list scar revision as an exclusion, so check your benefits. California state mandates may broaden coverage. |
| Anthem Blue Cross CA (CG-SURG-31, Treatment of Keloids and Scar Revision) | Treatment for significant functional impairment, or reconstructive treatment for a scar that varies significantly from normal after injury, disease, or treatment | Radiation up to 3 fractions, started within 3 days of keloid excision. Fractional CO2 requires limited movement plus a prior trial of silicone or pressure. Acne scar laser is cosmetic. |
| Blue Shield of California (Reconstructive Services) | Reconstructive surgery to improve function or create a normal appearance, following California law | May deny if only minimal improvement is expected. Requires clinical notes on symptoms, function, and prior treatments, plus color photographs. |
| Medicare (Noridian, California) | Repair of accidental injury, improvement of function, severe burns, and facial repair after serious accidents | No scar-specific policy; appearance-only and psychiatric rationales are excluded. Dermabrasion covered only for trauma, surgery, burn, or disease scars, not acne. Medicare Advantage plans may add their own criteria. |
| Medi-Cal (W&I Code 14132.62 and plan policies) | Reconstructive surgery to improve function or create a normal appearance; scar or keloid revision with uncontrolled pain, burning, or itching, impaired function, or an unstable scar | Prior authorization required. Health Net California covers radiation within 7 days of keloid excision and excludes vaccination scars, stretched piercing holes, and acne scar dermabrasion. |
| Kaiser Permanente | Reconstructive surgery under California law through internal referral | Kaiser’s published Northwest criteria require a scar present at least one year (unless keloid or hypertrophic) with loss of motion, pain, or significant disfigurement. Southern California does not publish separate criteria. |
| Humana (Cosmetic and Reconstructive Surgery) | Revision correcting an objective functional impairment from injury or medically necessary surgery | Standard techniques only (excision, Z-plasty, W-plasty, flaps, grafts). |
California Health and Safety Code section 1367.63 (HMOs and health plans), Insurance Code section 10123.88 (insurance policies), and Welfare and Institutions Code section 14132.62 (Medi-Cal) define reconstructive surgery as surgery on abnormal structures caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease, performed either to improve function or to create a normal appearance, to the extent possible.
In practice, this means a disfiguring scar from an accident, burn, or surgery may qualify on a California-regulated plan even when it does not limit movement. A plan can still deny a request if the expected improvement in appearance is minimal, but that decision must be made by a physician qualified in the relevant area. The California Department of Health Care Services has also confirmed that Medi-Cal managed care plans must follow this standard.
Important exception: many large employers use self-funded (ERISA) plans, which are governed by federal law and are not subject to California’s mandate. Your HR department or the back of your insurance card can tell you which type you have.
Under the federal Women’s Health and Cancer Rights Act, group plans that cover mastectomy must also cover all stages of breast reconstruction, symmetry procedures on the other breast, and treatment of complications. Revision of mastectomy and reconstruction scars falls under this protection.
Most denials are documentation problems, not medical ones. A strong request includes:
Scar revision that does not meet medical criteria can still be done as a self-pay cosmetic procedure. Many scars, such as an old C-section scar, are also removed as part of a tummy tuck, and non-surgical options like CO2 fractional laser and Fractora can improve texture and color. We provide a clear, all-inclusive quote and financing options at your consultation.
Often, when the scar is from an injury, burn, surgery, or disease and causes a medical problem: limited movement, pain or itching that did not improve with conservative care, or a scar that bleeds, breaks down, or gets infected. Revision purely for appearance is usually excluded, although California law also covers surgery to create a normal appearance after trauma or disease on state-regulated plans and Medi-Cal.
Many plans cover keloid treatment when the keloid causes pain, itching, or functional limitation. Covered treatments commonly include steroid or 5-FU injections, cryotherapy, surgical excision, and radiation started within 3 to 7 days after excision. Aetna, Anthem, and Medi-Cal plans have published keloid criteria.
It can be. Aetna specifically covers revision of surgical scars that cause symptoms or functional impairment, and other plans accept scars from medically necessary surgery. A painful, itchy, hypertrophic, or keloid C-section scar has a much stronger case than a flat scar you simply dislike.
Sometimes. Aetna, Cigna, and Anthem cover fractional ablative CO2 laser for burn, traumatic, or surgical scars that limit movement, usually after silicone or pressure therapy failed. Cigna allows an initial course of up to six sessions. Laser for acne scars, color, or texture alone is considered cosmetic.
Almost never. Insurers classify atrophic acne scar treatments such as dermabrasion, chemical peels, resurfacing, and fillers as cosmetic. Acne keloids that are symptomatic are a separate diagnosis and may qualify.
Medicare covers repair of accidental injury, improvement of function, severe burns, and facial repair after serious accidents. In California, Noridian also covers dermabrasion for scars from trauma, surgery, burns, or disease, but not acne. Medicare does not cover surgery done for appearance or emotional reasons alone.
Medi-Cal follows California’s reconstructive surgery law, so revision can be covered to improve function or create a normal appearance after trauma, surgery, or disease. Plans typically look for uncontrolled pain, burning, or itching, impaired function, or an unstable scar, and prior authorization is required.
Elective surgical revision is usually delayed until the scar matures, about 12 months, and some plans require it. Keloids, actively growing hypertrophic scars, and contractures that limit movement can be treated sooner.
The cause and date of the scar, measurements and scar type, symptom scores, range-of-motion or other function testing, a record of silicone, pressure, or steroid injections you tried, color photographs with a scale, and the proposed treatment plan.
Ask the plan for the exact criteria used, add missing documentation, and request a peer-to-peer review with the medical director. California members of state-regulated plans can request an Independent Medical Review after the internal appeal. Self-funded employer plans follow a federal appeal process instead.
This page summarizes the following publicly available policies, laws, and clinical references:
Medically reviewed by Dr. Babak Moeinolmolki, MD, FACS, double board-certified through the American Board of Surgery and the American Board of Cosmetic Surgery, practicing in Los Angeles. Reviewed October 2026. Insurance policies change frequently and vary by plan; this page is general education, not a guarantee of coverage or legal advice. Confirm benefits with your insurer before treatment.