Will Insurance Cover Eyelid Surgery

Insurance and Medicare approval for functional eyelid surgery can vary and continues to evolve with healthcare changes. Eyelid problems exacerbate these issues.

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Eyelid lifting or blepharoplasty is considered medically necessary when it is used as a functional or reconstructive surgery.

Will insurance cover eyelid surgery. Yes it is definitely possible to have upper eyelid blepharoplasty covered by insurance. Jun 23 2015 The office evaluation and surgical treatment of many different eyelid conditions is covered by insurance if the eyelid condition is causing 33. Most insurance companies do not cover upper eyelid surgery.

The carrier will then either pre-authorize or deny the claim. The American Society of Plastic Surgeons notes that insurance companies will only cover the surgery when it is classified for reconstructive or functional problems such as ptosis drooping due to muscle weakness or nerve damage blepharochalasis eyelid swelling dermatochalasis excess skin herniated orbital fat excess fat floppy eyelid syndrome and. Jul 15 2016 Eyelid surgery is one of the few plastic surgery procedures that can be covered by insurance.

The eyelid skin must be resting on or in front of the patients eyelids causing a significant restriction of their peripheral visual field side vision. Does Medicare Cover Eyelid Surgery. Lower eyelid blepharoplasty however is not.

Will insurance pay for eyelid surgeryif it is affecting your vision. The only exception to this rule is breast reconstruction following a mastectomy which is protected by law. You may however have to provide a physicians note and high-resolution photos of your eyes in order to demonstrate the necessity of your blepharoplasty to improve your vision and quality of life.

When performed solely for cosmetic reasons eyelid surgery is considered to be elective and therefore cannot be covered by medical insurance. It is best to start by reading and understanding your benefits under your insurance policy. Plastic surgery procedures that are undergone for purely cosmetic purposes are not generally covered by health insurance.

If you notice vision obstruction your eyelid surgery may be deemed medically necessary and could therefore be covered by insurance. However there are a few restrictions. Caring for the health of the eyes becomes increasingly important with age as vision tends to naturally degrade over time.

A pre-authorization means that the insurance company agrees that eyelid surgery is medically necessary and they plan on covering the blepharoplasty or ptosis repair. Insurance companies will usually pay for reconstructive surgery to repair abnormalities caused by congenital defects trauma or disease. In certain instances insurance will cover upper eyelid skin removal if it is interfering with vision.

However eyelid surgery is sometimes covered by an insurance provider if it is deemed a medical necessity. If there is impairment of vision and upper or lower eyelid surgery is deemed medically necessary to improve the condition insurance may cover part or all of the cost. Because of this many seniors may want or need eyelid surgery to correct drooping and sagging that is caused by the loss of skin elasticity with age.

BCBSNC will provide coverage for Reconstructive Eyelid Surgery specifically Blepharoplasty andor Brow Lift Surgery when it is determined to be medically necessary because the medical criteria and guidelines shown below are met. Functional eyelid surgery removes heavy skin that hangs over the eyelash line interfering with the line of sight. If the procedure is being done to look better and for no functional benefit then insurance will not cover the procedure.

They list the following. Functional eyelid surgery removes heavy skin that hangs 1. If the procedure is purely elective ie not medically necessary insurance typically will not cover the eyelid surgery.

Will Insurance Cover My Eyelid Surgery Cost. For your own specific insurance is important that you read your policy determine your exact eyelid surgery insurance requirements. Only then that your insurance company may be able to pay for your surgery.

Eyelid surgery can be covered by medical insurance if it is deemed medically necessary. If the answer is yes then the next step is to submit all notes and testing to the insurance company. Insurance companies do not generally cover the lower eyelid blepharoplasty but upper blepharoplasty is usually covered if an examination by an 2.

Most people run into the issue of not having their eyelid surgery covered by insurance. Functional eyelid surgery removes heavy skin from the upper eyelid area when it is interfering with a patients line of sight impeding everyday activities such as reading driving or sending text messages. This means it has to improve your vision in some way or decrease eye irritation.

This is because it is considered a cosmetic procedure and those procedures are not covered by insurance plans. When blepharoplasty of the upper or lower eyelids is performed to improve ones appearance in the absence of any signs or symptoms of functional abnormalities the procedure is considered cosmetic and therefore not a covered service by. In order for a blepharoplasty to be covered by medical insurance the eyelid skin must be impairing your field of vision usually your peripheral or side vision.

Oculoplastic Surgeon Denver Eyelid Specialist Blepharoplasty Cosmetic Eyelid Surgery Tear Duct Surgery and Orbital Surgery 1800. Insurance companies do not generally cover the lower eyelid blepharoplasty but upper blepharoplasty is usually covered if an examination by an ophthalmologist determines that droopiness of the upper eyelid impairs vision. Insurance companies have strict guidelines for coverage of upper lid blepharoplasty.

Sep 9 2017 Eyelid surgery can be covered by medical insurance if it is deemed medically necessary. Oculoplastic surgeon denver eyelid specialist blepharoplasty cosmetic eyelid surgery tear duct surgery and orbital surgery 1800 emerson st suite 200 denver co 80218 303 468 8844. When Does Insurance Cover Eyelid Surgery.

You will need an eye exam proving your lost field of vision as well as photo documentation and a statement on how your droopy eyelids are impacting your daily life.

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