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Will Insurance Pay for Eyelid Surgery?

Will Insurance Pay for Eyelid Surgery?

Commonly referred to as blepharoplasty, eyelid surgery is one of the most popular cosmetic procedures in the world today. Currently, this procedure is the fourth most common elective surgery in the west, while it ranks first in Asia. One of the numerous benefits associated with blepharoplasty is its ability to repair and reconstruct a sagging eyelid. It also helps to remove eyelid folds, wrinkles, puffiness, and lines. But the most important question that people always ask is: Will my insurance pay for eyelid surgery? This question has become quite common because most insurance companies do not cover cosmetic surgery.

Therefore, if you want to undertake an eyelid surgery purely for aesthetic purposes, then you might have to pay the total cost of the procedure from your own pocket. Most insurers claim that eyelid surgery should be deemed a cosmetic procedure and not medically necessary. In legal terms, it is still not very clear when a surgical procedure becomes medically important. Unfortunately, the decision to deny patients insurance reimbursements by insurance companies has become detrimental and risky to many deserving patients. Sometimes these procedures are the only solution to major health complications and therefore they should be covered.

Conflicting Views of What Is Medically Necessary

Nevertheless, there are certain medical coverages that include some specific eyelid procedures. For instance, if the surgery is for medical reasons, your insurance company may be compelled to pay for it, but under certain terms and conditions. A perfect example is when your eyelids hamper your vision. But for you to be covered, a doctor has to perform a vision test to confirm that there is total obstruction. Only then that your insurance company may be able to pay for your surgery. Therefore, it is important for you to consult your insurer on this issue before you go for the surgery.

Although eyelid surgery is one of the most commonly denied procedures, there are several other similar plastic surgeries that are frequently denied, including breast augmentation and nose reconstruction. Health experts argue that the difference between cosmetic surgery and reconstructive surgery is often misunderstood, particularly because most insurers have removed medical care from the hands of doctors and given it to administrators while pretending to be reducing the cost of health care. Unfortunately, the pressure to save money has influenced bad decisions that are often detrimental to the patients. It is an issue that needs to be looked at carefully.

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  • Julie Jackson
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    'My experiences at Associates in Plastic Surgery have all been outstanding. I have been a patient for more than 10 years. Dr. John Alspaugh is pleasant, patient and very informative. He listens to you and your concerns. I am always very happy with the results. Cheryl, his nurse is amazing! Go see her! She is sweet and knowledgeable. She eases my nerves and answers all of my questions and concerns. She even makes me laugh. Wonderful, caring staff.