Images of eyelid surgery correct drooping or sagging upper eyelids, remove excess fat and skin from the eyelids and tighten loose muscles. A common question which most of my patients ask is, “Does health insurance cover blepharoplasty?” or “Are images of eyelid surgery covered by insurance ?”
Have you ever considered getting eyelid surgery but hesitated due to the high cost? What if we told you that your insurance might cover it? Yes, you read that right.
Eyelid surgery is considered a cosmetic procedure, but Health Insurance will cover it if it’s medically necessary.
Does insurance cover blepharoplasty?
Blepharoplasty is medically necessary for functional or reconstructive eyelid lifting.
It’s necessary to lessen eye irritation or increase vision. Below are medically necessary blepharoplasty conditions:
- Excessive eyelid skin
- Persistent eyelid swelling
- Drooping eyelids skin,
- Stretched-out eye muscle tendon
- limit the near or far invention.
- Upper eyelashes are restricted due to excess skin.
- Chronic irritation of the eyelids
- Problems in wearing eyeglasses.
Blepharoplasty Health Insurance Coverage Requirement:
Insurance companies require a few things to cover your eyelid surgery.
Doctor Report:
Health insurance companies require Doctors’ inspection reports showing the following details to cover the cost:
- Location of the lids
- Poor visual range
- a patient complained about the upper lids interfering with specific activities (driving, reading, etc.).
- Standard oculoplastic test to determine whether the lid is within less than 2 millimeters of the pupil.
External Ophthalmic Pictures:
These are high-resolution images of the eyelids and eyes. To meet the criteria, extra eyelid skin must be seen to be less than 2 millimeters from the center of the pupil. The frontal and side pictures must be clear to watch.
Visual field test:
Ophthalmologists undertake this exam in which he raise and tape eyelids and check the visual areas.
Health insurance covers upper eyelid surgery based on the difference between tape and untap visual fields.
Does Medicare cover eyelid surgery?
Medicare covers medically necessary eyelid surgery, such as when the droopy eyelid interferes with vision. In this case, the surgery is considered a functional or reconstructive procedure rather than a cosmetic one.
However, if the eyelid surgery is purely cosmetic and does not serve any medical purpose, Medicare will not cover it.
Medicare does not pre-authorize anything as it has well-defined criteria that most oculoplastic surgeons know. Through inspection and testing, surgeons assess whether Medicare would normally cover a patient’s eyelid surgery.
Does insurance cover ptosis surgery?
Ptosis surgery is generally not covered by health Insurance. However, health insurance coverage may be available if your ptosis is severe enough and causes significant visual obstruction. The problem interferes with your daily living activities.
Ptosis surgery may be considered medically necessary and covered by health insurance if the drooping upper eyelids block your vision and adversely impact your life.
Frequently Asked Questions?
Who is the best candidate for eyelid surgery?
- Individuals that are healthy and do not have any medical issues that can delay healing
- Nonsmokers
- Individuals with a positive attitude and attainable aims
- Individuals who do not have major eye issues
Your plastic surgeon will extensively examine your facial anatomy and explain which surgeries could best address your issues.