Eyelid Surgery Covered by Insurance?
Eye lid surgery, also known as blepharoplasty, is a popular cosmetic procedure that can help improve a person's appearance by removing excess skin and fat from the upper and lower eyelids. While many people undergo eyelid surgery for aesthetic reasons, it can sometimes be covered by insurance if it is necessary for medical reasons.
What is Eyelid Surgery?
Blepharoplasty involves two main types of procedures: upper eyelid surgery and lower eyelid surgery. Upper eyelid surgery focuses on the upper eyelids, while lower eyelid surgery addresses the lower eyelids. Both procedures can be performed for cosmetic reasons to improve the appearance of the eyes, but lower eyelid surgery is typically not covered by insurance.
When Is Eyelid Surgery Covered by Insurance?
Insurance companies generally cover eyelid surgery if it is deemed to be a medical necessity rather than a cosmetic procedure. This type of surgery is known as functional eyelid surgery, and it can be covered by insurance if it is necessary to improve vision or prevent vision impairment. To be covered, the surgery must meet certain requirements, such as clear visual field test results and a doctor's note documenting the need for the procedure.
How to Qualify for Eyelid Surgery Coverage?
To determine if you are a candidate for eyelid surgery coverage, you should consult with an oculoplastic surgeon. At the consultation, the surgeon will perform a thorough evaluation, including a physical examination, visual field testing, photographic documentation, and discussion with the patient about their concerns and expectations. If it is determined that eyelid surgery is necessary and meets the insurance company's coverage criteria, the next step is to submit all relevant documentation and testing to the insurance company for pre-authorization.
What are the Costs of Eyelid Surgery?
The cost of eyelid surgery varies widely depending on various factors, such as the extent of the surgery, the experience of the surgeon, and the geographic location of the hospital or clinic. Generally, the cost of upper eyelid surgery ranges from $4,120 to $10,750 according to 2020 data, not including anesthesia or additional facility fees. If insurance covers part of the cost, the patient may be responsible for a copayment or coinsurance amount.
What Are the Risks of Eyelid Surgery?
Like any surgical procedure, eyelid surgery carries certain risks, including infection, complications, Blepharoplasty can potentially cause significant visual impairment, diplopia, corneal exposure, upper lid retraction, scarring, and changes in eyelid position or sensitivity.
Despite the potential risks, eyelid surgery can be a very effective way to improve the appearance of the eyes and enhance self-confidence. If you are considering eyelid surgery for medical reasons, it is crucial to speak with a qualified oculoplastic surgeon to ensure that the procedure is necessary and to understand the potential costs and coverage options.
This article provides a comprehensive overview of eyelid surgery coverage by insurance and what to consider if you are considering the procedure for medical reasons.
