Is Blepharoplasty Covered by Health Insurance?

Posted on Tuesday, February 6th, 2018 by Dr. Binoy Jani

Is blepharoplasty covered by health insurance?

Blepharoplasty, also known as eyelid surgery, is a common cosmetic surgical procedure performed to remove sagging, drooping skin on the upper eyelids and wrinkles, lines and puffy bags on the lower eyelids. The result is a softer and more energetic eye appearance.

When performed solely for cosmetic purposes, blepharoplasty is not covered by health insurance. The procedure may, however, be covered by insurance if it’s performed for medical reasons. Our Fredericksburg and Culpeper ophthalmologists at Vista Eye Specialists explain more in this blog post.

When Is Blepharoplasty a Medical Necessity?

Excess skin on the upper eyelids can do more than just affect one’s facial appearance. In some cases, the eyelid skin can droop so low that it hangs over the eyelashes and interfere with the line of sight. When this occurs, everyday tasks like reading can become uncomfortable and difficult, while driving can be potentially dangerous.

Blepharoplasty is considered to be a medical necessity when the upper eyelid skin causes visual impairment. During the procedure, the surgeon eliminates loose skin and removes or repositions heavy tissue and fat to restore an unobstructed line of sight. Blepharoplasty can also relieve other forms of physical discomfort, including headaches, eyestrain and skin irritation caused by folds of skin that rub up against each other. Although these symptoms are not considered to be medical emergencies, they can be dramatically reduced with blepharoplasty. Following the procedure, many patients experience a boost in their overall quality of life.

Blepharoplasty performed on the lower eyelids is never considered to be a medical necessity and therefore is never covered by medical insurance.

Visual impairment is determined by a visual test conducted by a board certified ophthalmologist or optometrist. During the visual test, your doctor will document restriction in the visual field and submit it to your insurance provider.

Learn More about Blepharoplasty

Whether performed for cosmetic or medical reasons, blepharoplasty can be a life-changing procedure. To discuss the procedure in detail with a board certified ophthalmologist, schedule a consultation with Vista Eye Specialists. One of our trusted eye doctors can discuss your concerns and goals with you to determine the best course of treatment.

To learn more about blepharoplasty, please schedule an appointment with Vista Eye Specialists. Contact us by calling 1-888-EYE-JANI (393-5264) today.