Is upper eyelid surgery ever covered by insurance?

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Upper eyelid surgery may be covered by insurance if your eye lids' position interferes with your peripheral vision. This can happen if your lid covers a portion of the center of your pupil, called "ptosis," OR if your lids have excess skin hanging over your lashes, called "dermatochalasis". Patients with this condition feel like they look tired from lid heaviness.

In medical circumstances, insurance companies will generally require the patient to have a visual field test with an ophthalmologist. They may also require pre-certification photos identifying the condition and the patient's plan for surgery.

The surgeries I do to correct these eye lid conditions are about an hour long and are performed under IV twilight sedation, not general anesthesia. It is not a painful procedure and patients find their recovery consists of minor swelling and discomfort which is normally controlled with cold compresses and pain medication. Most patients find their bruising is minimal, generally lasting about 2 weeks, which is also when most patients are back to a normal routine. Patients can certainly benefit from the surgery not only functionally in helping their vision, but the cosmetic benefits of looking less tired and more refreshed are also admired.
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West Palm Beach Oculoplastic Surgeon