Traditional Brow Lift Insurance Coverage

If you have significant brow ptosis as it sounds like you have, I would not recommend doing an endoscopic anyways. I always favor the endoscopic approach as I feel it is a nice approach. But if you have significant ptosis then an open approach would be the better option.

Hope that helps guide you somewhat.

There is an objective test that an Ophthalmologist can perform to determine visual field obstruction.  If a patient has this problem, then a surgeon can determine if eyelid surgery alone will not correct this problem.  In a few selected cases insurance might cover brow lift as well.  Make sure your surgeon does an appropriate examination to determine specific cause of your visual field issue.

The vast majority of brow lifts in my practice are performed for cosmetic purposes.  The only setting in which a brow lift would be considered a covered procedure for insurance purposes is if a visual field obstruction has been determined and the upper eyelids have been ruled out as a cause.  Again, the vast majority of peripheral visual field obstructions are caused by excess upper eyelid skin making upper eyelid Blepharoplasty the most immediate option.  If an upper eyelid Blepharoplasty fails to address the visual problem and a patient has significantly low brows, a brow lift can be considered.  Whether the brow lift is covered or not varies with insurance companies and individual policies.

First it must be determined if your upper lids are a significant problem.  This will see if it is medically necessary.  What most insurance companies want is a visual field confrontation test.  It is a test to see if you have visual field cuts from your droopy upper lids, and how bad they are.  You can't cheat this test as is it a standardized machine.  After that, the surgeon can determine if your problem is one of brow descent or isolated droopy eyelid skin.  There is wide variance in what an insurance company will pay for, and how much. 

I have done many brow lifts recently under insurance coverage, and in every case the patient and I decide what technique we'll use.  The code for brow lift is the same no matter the technique (and the surgeon and surgical center are paid the same).  In some cases, if a fixation device, such as an endotine, is used you may incur additional costs that the insurance may or may not pay for. 

Without a cosmetic rider in the medical insurance policy, it is very unlikely to show that the browlift is medically necessary, and hence something that an insurance company should cover. However, insurance company also can not determine which type of lift is best for you.

I have never heard of an insurance company covering a browlift which is a cosmetic procedure.  Therefore, I could not tell you if they could dictate the operation chosen. In all likelihood I would say that they can not mandate a specific operation.

Brow lifts are a very effective surgery to reposition the brow. In some patients, they can help improve the range of vision by elevating skin may be blocking a portion of their field of vision. Insurance coverage in these situations is quite variable. Your best bet is to be evaluated by a board-certified plastic surgeon with a great deal of experience in brow lifts and facial rejuvenation. They will assess your brow and determine if you're a candidate. They may also recommend an evaluation by an ophthalmologist for field of vision tests. With this information, they can comprise a insurance authorization letter. Ultimately it depends on your insurance company and your personal policy if the surgery will be covered.
 

Medical insurance companies often require a letter of medical necessity or pre-determination of benefits prior to the authorization of any medical service. One rule of thumb is to provide them with as much documentation of your medical complaint as possible. You must also be prepared to document how you have tried non-surgical means to correct the physical problem that you are requesting evaluation for.
This may be a difficult burden for you to overcome for an insurance approval for a traditional brow lift surgery which the insurance company will determine is not medically necessary.

If you have seen an ophthalmologist and they have determined that you have visual field obstruction and need a brow lift, that should be all the insurance needs to know. Whether it is an open coronal lift, an endoscopic lift or a direct brow lift above the eyebrows shouldn't be their decision.