Is Eyelid Surgery Covered by Insurance?

Many of my older patients come in with significant excess skin over their eyes in their upper eyelids. They feel like their eyes are heavy and want to know if eyelid surgery is covered by insurance or medicare. The answer here is that it depends. If you have excess eyelid skin that is causing visual impairment or peripheral visual loss, this must be tested by an ophthalmologist or optometrist and documented for the insurance company to approve the surgery.

Despite Medicare or an insurance company approving upper eyelid surgery or blepharoplasty for medical reasons, this does not mean they will actually pay the surgeon. They may contest the surgery after the fact on grounds that it was “cosmetic”. There have been instances where payment for blepharoplasty is received from the insurance company, and then Medicare or the insurance company turns around and sends a letter stating the procedure was cosmetic and they insist on a refund.

For this reason, at Funk Facial Plastic Surgery, eyelid surgery or blepharoplasty is NOT covered by insurance.

Dr. Funk is a board certified facial plastic surgeon specializing in eyelid surgery or blepharoplasty.

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