Is ectropion repair covered by insurance?

Question

I didn't know what was wrong with my eyes so I asked on here. I was told its genetic mild ectropion. Would insurance cover to repair it? My eyes do get irritated easily and now I'm thinking it's probably from that.

Kenneth D. Steinsapir, MD · Answer

True ectropion, where the lower eyelid gaps away from the eye.  That situation is generally covered by health insurance.  Your situation is a normal variant.  Generally changing that is considered cosmetic surgery and is not covered.  Some surgeons attempt to bend the rules for a variety of reasons.  However, you are going to have to be very careful here.  Repairing your situation is quite complex.  Sometimes the wises choice may be to do nothing.  I would recommend consulting with oculoplastic surgeons who focus on advanced aesthetic eyelid surgery.  Be aware that some are much more reconstructive than aesthetic so choose wisely.

Jose Barrera, MD · Answer

I agree that you seek the opinion of an ophthalmologist to determine whether you have dry eyes and the position of the lash line in comparison with your eye. An ectropion repair is very possible but the cause of the condition should be investigated further.

Chase Lay, MD · Answer

very often this is repaired and performed using insurance coverage.  Go see an ophthalmologist and oculoplastic surgeons first.  It will require a lot of documentation to get it approved given your young age but it may work out for U.

Ronald V. DeMars, MD (Retired) · Answer

The best answer anyone can give you is Maybe. You'll never know until you see a surgeon and have their office contact your insurance company.

Is ectropion repair covered by insurance?

Answers (4)

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