Can eyelid surgery be covered by insurance?
The short answer: Sometimes. If there is a functional component like improving vision it is often covered. Lower lid surgery is rarely covered by insurance. We provide more detail below. Remember your insurance policy dictates what is covered, and although we may agree that a procedure is medically needed, your policy and the insurance company have the final say. During your consultation with us we can assist you in this area.
Whether insurance covers it or not eyelid surgery provides an awesome fresh look.
What is Eyelid Surgery?
Blepharoplasty (eyelid surgery) is a procedure that is performed to address excess skin and fat of the upper and lower eyelid. It is one of the most popular cosmetic procedures performed in the United States. Many patients choose to undergo upper and/or lower blepharoplasty procedures to dramatically improve signs of aging and improve a tired or upset appearance.
Blepharoplasty surgery is not only performed for cosmetic purposes but can also improve visual function. Although lower blepharoplasty is more often not covered by health insurance policies, upper eyelid surgery may be covered in cases where the droopiness of the upper eyelid impairs vision or eye function. In order for eyelid surgery to be covered by medical insurance, it must be deemed medically necessary. If your eyelid droopiness is indeed causing problems with your vision affecting driving, working, or performing other activities of daily living, this may be the
case for you.
Eyelid Surgery: How to qualify for insurance?
The first step to begin this process is to check if your insurance company offers coverage for eyelid surgery. Next, you will need to be evaluated by an eye doctor (ophthalmologist) for a visual field test to figure out how much of your vision is affected by your eyelids. Some insurance companies will also require a comprehensive ophthalmology exam. You will then need a consultation with a surgeon who performs eyelid surgery, such as a facial plastic surgeon. This is also an important step to determine if your vision problems are related to excess skin (dermatochalasis), stretching/weakness of the muscle that opens your upper eyelid (ptosis), heaviness and sagging of your eyebrow (brow ptosis) or other causes. This will help guide the best course of action to improve your vision and appearance!
At your consultation, photos will be taken to document your eyelid position. This information is then sent to your insurance company for pre-authorization and approval.
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Whether you are seeking functional improvement or looking for a more youthful appearance around the eyes, blepharoplasty may be a good option for you! To get more information about blepharoplasty (eyelid surgery), or if you would like to schedule a consultation with one of our providers (Dr. Peter Hilger, Dr. Sofia Lyford-Pike, Dr. Jenna Van Beck), please call the Hilger Face Center in Edina, Minnesota at 952-844-0404 or submit a consultation request form: