Tuesday, August 19, 2014

Does insurance cover eyelid surgery?

Many of patients notice the heavy feeling over their upper eyelids with excess skin and wonder if insurance will pay for upper eyelid surgery or an eyelid lift. The answer is that it depends. In order for insurance to agree to pay for this procedure (which no insurance will guarantee) peripheral visual field deficits must be clearly documented by your ophthalmologist. Then, these results along with all the paperwork must be submitted and approved by the insurance company.

In the past, I have gone through all the paperwork and requirements of insurance carriers to perform upper eyelid surgery on patients. I was reimbursed by the insurance company initially, only to be asked to refund them as they deemed this procedure cosmetic. I therefore now no longer take insurance for any eyelid surgery. Yes, I know there can be visual deficits due to excess eyelid skin but insurance companies have been too difficult to deal with regarding this procedure.

Dr. Funk is an eyelid surgery expert in Houston, TX.