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Is Any Part of the Surgery Covered by Insurance?

asked 1 year ago by Ogden in Ogden, Utah
Latest answer by William Portuese, MD
Question viewed 612 times
Tags: insurance

I like many people of my age have excess skin in my eyelids and I have many small skin tags that need to be removed. Is any part of this surgery covered by insurance?

19 answers to Is Any Part of the Surgery Covered by Insurance?

+1

Upper eyelid surgery and medical insurance coverage

Insurance will only cover upper eyelid surgery when there is a severe amount of excess skin called dermatochalasis, which is a medical condition whereby the excess skin pushes down on the eyelashes creating a visual obstruction. Approximately 30% of the visual field needs to be obstructed before medical insurance will pay for a medically necessary blepharoplasty.  
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Insurance may cover eyelid surgery.

Different insurances will give different benefit levels.  All insurances will require you to see an ophthalmologist and get a visual field test which would show that you have parts of your vision blocked by the excess skin.  This would be a" functional" as opposed to a "cosmetic" problem and many insurances would cover it.  The skin tags are a cosmetic problem but perhaps your surgeon could snip most off quickly at the time of your upper eyelid surgery.... more
Jeffrey M. Darrow, MD

Boston Plastic Surgeon
+1

Excess skin over the eyelids may be covered by insurance

Excess skin over the eyelids may be covered by insurance if it is interfering with vision. Peripheral vision is documented by visual field within 30 degrees of fixation. Skin tags are usually not covered unless they’re causing a functual irritation or a lesion that needs to be biopsied.
Joseph A. Eviatar, MD

Bronx Oculoplastic Surgeon

www.ChelseaEye.com

+1

Eyelid surgery may be covered by insurance...

If you have droopy or sagging eyelids that interfere with your vision, then there may be a possibility insurance will cover it. Insurance will only cover upper lid surgery if there is a documented visual field impairment. Otherwise the procedure is considered cosmetic and would not be covered. I would recommend making an appointment with an ophthalmologist for a visual field exam to see if you qualify for your surgery to be covered
Andrew Miller, MD

Edison Facial Plastic Surgeon

www.associatesinplasticsurgery.com

+1

Insurance may cover an upper blepharoplasty

Hi Ogden, Insurance may indeed cover a portion of your upper blepharoplasty; however, this requires that you are seen by an ophthalmologist and have your visual fields tested to determine if you meet criteria to qualify.  Most plastic surgeons will have you sign a waiver stating that you are responsible for paying what insurance doesn't or won't pay. Regarding the skin tags, these should also be evaluated by your plastic surgeon (or dermatologist).  If these are... more
P. Daniel Ward, MD

Salt Lake City Facial Plastic Surgeon
+1

Insurance can sometimes cover upper eyelid surgery (blepharoplasty)

If you have excess skin of the upper eyelids that is interfering with your vision, an upper blepharoplasty can help your symptoms.  This can be both functional (which could be covered by insurance) as well as cosmetic.  You may have to consult with an ophthalmologist to document that you have visual field deficits, and therefore, need the surgery for "functional" reasons. Please ask your health insurance carrier for their specific requirements Best wishes, Dr.... more
William Bruno, MD

Beverly Hills Plastic Surgeon
+1

Yes insurance may pay for upper eyelid surgery

Excess skin of the upper eyelids can cause loss of peripheral visual field.  This is dangerous while driving a car.  Most insurance companies will pay for correction or upper blepharoplasty.  To see if your insurance company will pay usually requires a letter from your board certified plastic surgeon, a copy of a peripheral field vision test, and photographs.  The peripheral field visual test can be done by your optometrist.
Randy Proffitt, MD

Mobile Plastic Surgeon
+1

Eyelid surgery - insurance

Insurance will cover upper eyelid surgery (but not lower) if you see an eye doctor and get visual field testing that shows that the extra skin is impairing your vision.  Each insurance is different in how picky they are but they'll usually cover this surgery.  The skin tags are unlikely to be covered.  However, the medical biller at the plastic surgeon's office you go to will help you through this process with your insurance. Dr. Cat Begovic M.D. more
Catherine Huang-Begovic, MD

Beverly Hills Facial Plastic Surgeon
+1

If upper "droopy" lids block vision, this is usually covered by insurance.

"Visual field testing" is a usual part of the pre-operative evaluation for a patient undergoing an eyelid tuck. In the event that the eyelids are found to be obstructing part of the patients' vision, this is then NOT a purely cosmetic procedure, and IS generally covered by insurance. The "visual field test" is important "proof" that does usually need to be provided to the insurance company for them to pay for the procedure. Skin tags are considered... more
Debra Irizarry, MD

Crestone Plastic Surgeon
+1

Eyelifts are rarely covered by insurance

Upper eyelid surgery is usually not covered unless there is a documented problem with how you see (a visual field block). This requires specific testing to be done by an eye doctor. Another situation where insurance may cover your surgery is if the lid does not raise normally (ptosis). Other than that, blepharoplasy is considered cosmetic by most insurance carriers and is not covered. As far as the lower lids and skin tags are concerned- no luck.
Lawrence Iteld, MD

Chicago Plastic Surgeon
+1

Surgery Covered by Insurance

The same question keeps popping up every few months. Call your insurance plan to discuss. But in very RARE cases upper hooding lids that are proven to block visual fields, severe laxity of lower lids, and benign skin tags can be a covered benefit. I truly doubt! Dr. Darryl j. Blinski
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Is Any Part of the Surgery Covered by Insurance?

Upper eyelid surgery sometimes can be covered by insurance if it is causing a visual problem.  Get a formal consultation with an Oculoplastic surgeon to see if you meet the criteria that your insurance company requires.
Sam Goldberger, MD

Beverly Hills Oculoplastic Surgeon

www.neweyelids.com

+1

Using health insurance to cover cosmetic surgery.

Dear Ogden One of the reasons that we are in the health care mess we are in is that doctors and patients have abused the system by performing cosmetic surgery and claiming that it was medically necessary.  This means that health plans have become very strict regarding what is and what is not covered.  Have a frank discussion with you oculoplastic surgeon regarding this subject.  Once trend we have found is that health insurance plans with high deductibles have so rigged... more
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon
+1

Excess upper eyelid skin

Excess upper eye lid skin is often best treated with a blepharoplasty.  This is not covered by insurance.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Insurance coverage for excessive eyelid skin

Insurance companies are getting stricter every day in terms of coverage. First of all lower lid excess skin is considered cosmetic and is not covered. Upper lid excess skin may be covered if the skin fold drops below the edge of the eyelid and affects the upper visual field. The insurance companies decides on coverage based on symptoms, close-up eyelid photos, and visual field tests which are performed with special equipment. They generally cover skin tag removal if performed in office. more
Peter T. Truong, MD

Fresno Oculoplastic Surgeon

www.facialsurgerydr.com

+1

Insurance Coverage for Blepharoplasty

It is possible to obtain insurance coverage for eyelid surgery.  A simple way to tell if you may be a candidate is to determine if the skin of your upper eyelids comes into contact with your eyelashes.  If they do not, there is almost no chance that you would have enough visual impairment to qualify for insurance coverage. The actual determination is from a visual field examination completed by an ophthalmologist.  This gives an objective measure of the amount of impairment... more
Joseph Campanelli, MD

Minneapolis Facial Plastic Surgeon
+1

Blepharoplasty covered by insurance?

Upper blepharoplasty would be covered by insurance completely if there is visual field obstruction.  This would require a visual field exam, usually performed by an optometrist.  If your lower fields are affected, the only indication for insurance payment is ectropion.  This means that your lower eyelid turns outward.  Good luck!
Jason R. Hess, MD

San Diego Plastic Surgeon
+1

Eyelid surgery covered by insurance?

Upper eyelid surgery would be covered by insurance if the excess skin is causing visual obstruction, or if true eyelid ptosis (droop) exists.  Lower eyelid tightening might be covered if the lower eyelid is stretched downward, causing irritation of the sclera.  Additional rejuvenative procedures are not covered, though.
Carmen Kavali, MD

Atlanta Plastic Surgeon
+1

Lower Eyelid Surgery and Insurance

Lower eyelid surgery is typically deemed cosmetic and is not covered by insurance.  The only exception to this is in situations where a patient has such severe lower lid laxity that the conjunctiva of the lower lid shows (senile ectropion), insurance will cover a procedure known as a tarsal strip. However, this procedure is limited in the cosmetic benefit it offers patients.
Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

www.drprendiville.com

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