Your surgeon makes more money having you self-pay than using your health insurance. If the surgeon participates with your health insurance, this is a type of health insurance fraud. They are making you pay for something that is covered by your health insurance. You should contact your health insurance and advocate for yourself regarding this point. If your surgeon participates with your health insurance they can often force that surgeon to accept your coverage but this won't happen if you don't advocate for yourself. Please understand that some surgeon (generally the best aesthetic eyelid surgeons) don't participate in health insurance and they are under no obligation to work with your insurance. I do think that you would benefit from an anterior levator resection ptosis surgery. However, you need to make sure that your surgeon will also fix the upper eyelid crease. Your crease heights are affected by the disinsertion of the levator aponeurosis tendon. In addition to the ptosis surgery, you need crease lowering, and an anchor blepharoplasty fo for a new hard crease at a lower location (6-7 mm) and also help the upper eyelid lash ptosis.