Q: When is Blepharoplasty Medically Necessary?


When is blepharoplasty considered to be medically necessary? The skin on my upper eyelids hangs down over my eyelashes. It tends to push my eyelashes into my eyes and makes it hard for me to use my computer without tilting my head back. My eyes also get tired and my vision blurs towards the end of the day. I would like to get this fixed, but I am not sure if insurance typically covers this sort of thing.  When I talk to my insurance company about this, is there anything in particular that I should mention?

A: Blepharoplasty covered by insurance

If you have excess upper eyelid skin which hangs down over your eyelashes and interferes with your vision, then you likely have a condition that would be covered by insurance.

Typically, the insurance companies need to see photos and proof of your visual field deficit (obstructed vision) by an ophthalomologist examination prior to approving your surgery. Depending on the type of insurance you have, this procedure would be considered reconstructive, and not cosmetic, therefore being covered by your insurance plan.

Please consult with a board certified plastic surgeon or oculoplastic surgeon to receive more information on the insurance implications of your particular case.