Does insurance ever pay for malar mound/festoon treatment?

Question

Wondering if insurance ever pays for malar mound treatment since it is disfiguring and caused by a defect in the skin. Does it depend on the severity. Mine are mild to moderate.

Sheila S. Nazarian, MD · Answer

No. In general, the removal of festoons is considered cosmetic and therefore, not covered by insurance. Sorry to say.  
My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Larry S. Nichter, MD, MS, FACS · Answer

It would be rare for insurance to pay/cover malar mound/festoons treatment as it is considered cosmetic. Unless their is a functional deficit it is highly unlikely that it will be covered. RF and lasers may be your best consideration#MalarMoundTreatment#FestoonTreatment

Sean R. Weiss, MD, FACS · Answer

It is very unlikely that insurance will cover under eye bags, malar mounds or festoons. They typically are considered cosmetic and nit medically necessary.  Best regards.

Kenneth D. Steinsapir, MD · Answer

An occasional individual has festoons so severe, they fill up the eye glasses and interfere with vision.  Let me stress, that is a very rare situation.  Generally these are considered cosmetic no matter how disfiguring they are.  Not saying that is right.

Adam Scheiner, MD · Answer

Festoons and Malar mounds are area of swollen skin the area of the lower eyelid and cheek region. They can wax and wane and although some case occur in certain families and a young age, most have their genesis in sun exposure over time.Keeping the skin protected with daily use of broad spectrum sunblock can help to prevent worsening of this condition.Unfortunately, insurances have in general not been willing to cover surgery to help treat this condition. I hope this was helpful.

Brett S. Kotlus, MD, MS, FACS · Answer

Insurance will not pay for festoon treatment because it is a cosmetic issue, just as insurance doesn't cover cosmetic lower eyelid treatments.The best correction depends on your specific appearance, but often includes laser treatment in combination with volume replacement.

Samuel Baharestani, MD, FACS · Answer

Thank you for sharing your case.  Unfortunately, most insurance plans would consider malar edema and festoon treatments to be cosmetic.  Good luck!

John McCann, MD, PhD · Answer

Hi veronica121,Thanks for your question. This is a common question from patients with lower lid bags or festoons. Unfortunately, insurance companies rarely pay for the surgical repair of lower lid festoons. Rarely, if they impede your vision, while reading for example, than the insurance companies may deem the procedure "functional or visually-signficant" and then pay for it.I would recommend a consultation with a skilled oculoplastic surgeon in your area who has experience dealing with insurance approval for functional lid surgery. That would be your best bet. Good luck!

Does insurance ever pay for malar mound/festoon treatment?

Answers (8)

More Eyelid Surgery Questions

Lump under my right eye following upper and lower Blepharoplasty, what is it? (photos)

What is wrong with my eyes? Why don't they look level? (Photo)

What's the best treatment for crepey skin under my eyes?

What can I expect specifically from getting the injection for a chalazion? How soon after can I wear makeup? (Photo)

Upper eyelid surgery. Can I put any moisture cream on my eyelid to help with the dry sensations?

After eyelid surgery 6 weeks ago, I'm left with a white line along my upper eyelash line both sides. Will this go away?

WE SEND PRETTY
EMAILS