Over the past few years, eyelid surgery, which is referred to as blepharoplasty in medical circles, has only gained more popularity among those well-versed in cosmetic surgery. The surgery improves the appearance of the eyes and your overall facial aesthetic and reduces the signs of aging to provide a refreshed and more youthful look. Even better, the surgery also has functional benefits for those who have severely sagging eyelids. This condition can cause serious issues, including but not limited to obstructed vision. Luckily, eyelid surgery can lift this skin to clear your vision. It can also reduce eye strain, fatigue, irritation, and heaviness. If this surgery sounds too good to be true, the catch is that insurance companies will not usually cover its cost. That being said, there are exceptions to this rule. Below, we answer the question, “How can you get insurance to pay for eyelid surgery?” and share tips so you can do it for yourself.
How Can You Get Insurance to Pay for Eyelid Surgery?
Health insurance companies do not offer coverage for cosmetic surgery because it is not deemed “medically necessary.” However, eyelid surgery can be done for several reasons beyond aesthetic benefits. If it is determined that eyelid surgery is medically necessary, it may be covered by insurance.
Vision Issues
If your eyelids impact your vision, eyelid surgery may be medically necessary. Eyelid sagging can droop so low that it can block your vision. This can make daily activities very difficult, including driving and reading. Such complications can impact your professional and personal life, which can make it more likely that your insurance provider will cover the cost of the procedure. It is important to work with an oculofacial surgeon to determine if the procedure is necessary to correct your vision complications.
Impact on Daily Activities
Sagging eyelids that impact your vision can impact your daily activities. Many people try to raise their eyebrows to compensate for the skin sagging. However, this can lead to headaches and further impact your overall quality of life. If you struggle with reading, driving, or any other daily activities, eyelid surgery may be necessary. Consult with an oculofacial surgeon and keep detailed documents of your experiences.
Ptosis Diagnosis
If a medical professional has diagnosed you with ptosis, eyelid surgery may be medically necessary. Ptosis is a condition that impacts the area around your upper eyelid, specifically the levator muscle. This muscle is responsible for raising your eyelid. Some people have ptosis because they are born with an undeveloped levator muscle. Others develop the condition over time due to the natural aging process or poor lifestyle habits.
Severe Symptoms
Sagging eyelid skin can lead some people to experience symptoms that are so severe they reduce their overall quality of life. Such symptoms include chronic eye irritation, headaches, and eye strain. This is often caused by constantly having to raise the eyelids to compensate for their sagging. If you experience these symptoms, talk with a surgeon skilled in oculofacial surgery and discuss the likelihood of having insurance providers cover your procedure. Be sure to document your symptoms to ensure they understand the severity.
Obtaining Insurance Coverage for Eyelid Surgery
Eyelid surgery is an effective option to address upper eyelid sagging, but you will need to take a few steps to get your eyelid surgery covered by insurance. Once you notice your symptoms, document them. Be specific in your documentation; include your symptoms and the severity of each symptom. Then, schedule an eye exam so you can be tested. If your doctor determines eyelid surgery is medically necessary, obtain a recommendation. Be sure to take photos of your eyes for your documentation.
Once you have a recommendation from a medical professional, check your medical coverage. You can determine what they cover and how much they cover. Contact them to verify the information you found. If necessary, submit a pre-authorization request to see if your insurance provider will deem the surgery medically necessary and provide financial coverage for it. If approved, schedule a consultation with a skilled oculofacial surgeon.
Eyelid Surgery in Virginia
If you want to improve the look of your eyes through eyelid surgery, contact Dr. Langelier and her team today to schedule an appointment!