Blepharoplasty Covered by Insurance: What You Need to Know

Are you considering blepharoplasty, commonly known as eyelid surgery, but worried about the cost? You may be surprised to know that in certain cases, blepharoplasty can be covered by insurance. Read on to learn more about the procedure, insurance coverage, and frequently asked questions.

What is Blepharoplasty?

Blepharoplasty is a cosmetic surgery procedure that aims to improve the appearance of the eyelids, either the upper or the lower or both. The surgery involves removing excess skin, fat, and muscle from the eyelids, resulting in a more youthful and refreshed look. Blepharoplasty can also improve vision in cases where sagging eyelids obstruct the field of vision.

The surgery is typically performed on an outpatient basis using local anesthesia with sedation. Recovery time varies but most patients can return to normal activities within a week or two.

Upper Blepharoplasty

Upper blepharoplasty involves removing excess skin, fat, or muscle from the upper eyelids. The incisions are made in the natural creases of the eyelids, making them virtually invisible once healed.

The procedure is often recommended for patients with droopy or sagging upper eyelids, which can make them appear tired or aged. In severe cases, droopy eyelids can also obstruct vision, making it difficult to perform daily activities such as reading or driving.

Lower Blepharoplasty

Lower blepharoplasty addresses the sagging or puffiness under the eyes. The procedure involves making incisions either on the inside of the lower eyelid or just below the lash line to remove excess fat or skin.

The surgery is recommended for patients with under eye bags or puffiness, which can give a tired or older appearance. In some cases, lower blepharoplasty can also improve the appearance of dark circles under the eyes.

Is Blepharoplasty Covered by Insurance?

Whether or not blepharoplasty is covered by insurance depends on the reason for the surgery. If the procedure is purely cosmetic and not medically necessary, most insurance companies will not cover the cost.

However, if the sagging eyelids are obstructing vision or causing other medical problems, insurance may cover the procedure. The decision is typically made on a case-by-case basis, and the patient must meet certain criteria to qualify for coverage.

Medical Necessity Criteria

To qualify for insurance coverage, the patient must provide documentation that the surgery is medically necessary. This may include:

• Visual field tests to show that sagging eyelids are obstructing vision
• Medical records showing that the sagging eyelids are causing headaches, neck pain, or other medical problems
• Documentation that other treatments, such as eye drops or medications, have not been effective in relieving symptoms

Even if the patient meets the medical necessity criteria, insurance may still only cover a portion of the cost. The patient may be responsible for co-pays, deductibles, or other out-of-pocket expenses.

FAQ: Frequently Asked Questions

1. How long does blepharoplasty take?

The length of the surgery varies depending on the extent of the procedure. Upper blepharoplasty typically takes 1-2 hours while lower blepharoplasty can take 2-3 hours.

2. Will I have scars after blepharoplasty?

The incisions are made in the natural creases of the eyelids, making them virtually invisible. Scarring is typically minimal and fades over time.

3. How long does it take to recover from blepharoplasty?

Recovery time varies but most patients can return to normal activities within a week or two. Swelling and bruising may last for several weeks.

4. Is blepharoplasty painful?

Most patients experience some discomfort and swelling after the surgery, but pain is typically minimal and can be managed with over-the-counter pain medication.

5. Can I wear contact lenses after blepharoplasty?

Patients are advised to avoid wearing contact lenses for at least a week following the surgery. Glasses can be worn immediately after the surgery.

Conclusion

Blepharoplasty is a popular cosmetic surgery procedure that can improve the appearance of the eyelids and even improve vision in some cases. Insurance coverage depends on the reason for the surgery and whether it is deemed medically necessary. If you are considering blepharoplasty, talk to your doctor about your options and whether insurance coverage may be available to you.