Will my insurance pay for Blepharoplasty?

Caitie, That is a good question and one that almost every patient asks. However, the insurance companies are very strict when it comes to covering procedures which may seem "cosmetic" in nature. Your best hope of getting it covered by insurance is to have a visual field test by an ophthalmologist. However,... more

If the upper eye lid covers the pupil, there is infection due to excess folds of skin, or an eye doctor can demonstrate decrease in visual field due to heaviness of the upper lid, insurance may cover various surgeries on the upper lid depending if the problem is excess skin, weak or detached levator... more

Insurance coverage for Blepharoplasty is limited to those patients whose excess upper eyelid skin or sagging brow causes a measurable impairment of their peripheral vision.  This condition must be documented by Visual Field testing, which evaluates the degree of obstruction caused by the hanging upper... more

Third party payers will not pay for a cosmetic blepharoplasty. However, some patients may exhibit visual field obstruction documented by a visual field test in the upper eyelids.  These patients may qualify for a functional blepharoplasty to relieve the obstruction.

If hooding of the upper eyelids interfere with your vision, your health insurance company may cover blepharoplasty surgery for the upper eyelids only. Most health insurance companies exclude coverage for cosmetic surgical operations such as the lower eyelid blepharoplasty or any complications that might occur... more

If your upper eyelids cover your visual fields in a demonstrable way then insurance should cover it. However, you will need to go to an ophthalmologist to have visual field testing and these test do not lie. Lower eyelids may sag and cause eyelid dryness and this may be covered, but once again you will need to... more

Typically, blepharoplasties are considered cosmetic surgery and are not paid for by medical insurance. However, if there is approximately 30% of visual field obstruction of the entire field of view, some insurance companies may consider paying for this as a functional problem. Always be prepared to pay for... more

Insurance coverage generally does not pay for cosmetic procedures. They will, however, contemplate paying for reconstructive or functional surgery. That having been said, each company determines the parameters by which they establish medically necessary blepharoplasty using reconstructive and functional... more

There is no insurance coverage for Blepharoplasty surgery unless it affects the field of vision; even then it may not be covered. If not, it is considered cosmetic and elective surgery.

In most cases, the simple answer is no. In the case of vision blockage due to ptosis or excess skin, there are very specific vision tests that insurance companies will demand as well as photo documentation before approving such a surgery. There are times a procedure can be approved because of medical necessity... more