Does Insurance Cover Eyelid Surgery?
There are certain criteria that must be satisfied for most insurance carriers (including Medicare – see below) to pay for part or all of your eyelid surgery. For any health care plan to cover surgery, a patient’s eyelids must restrict the superior field of vision resulting in some limitation of daily activities such as reading, writing, driving, sewing, etc. Photographs must be submitted and demonstrate significant narrowing of eye opening with a diminished distance from the upper eyelid to the light reflex (near the center of the pupil). Visual fields may also be required to further document constriction of the superior field. Visual fields are performed with the eyelids at rest and with the eyelids elevated to demonstrate the improvement expected with surgery. The predetermination process for commercial insurance may take a few weeks to a few months to complete. Lower eyelid blepharoplasty surgery is rarely covered by insurance or Medicare and is considered cosmetic in almost all cas
