Blepharoplasty, commonly referred to as eyelid surgery, is a popular cosmetic procedure that involves removing excess skin and fat from the eyelids.

This procedure can improve droopy eyelids, reduce bags under the eyes, and provide a more youthful appearance. However, many patients wonder if their insurance will cover this common procedure. The answer is primarily dependent on whether the surgery is considered cosmetic or medically necessary.

What is Blepharoplasty?

Blepharoplasty is a surgical procedure that is performed on the upper or lower eyelids. The surgery can involve the removal of excess skin, muscle, and fat from the eyelids to create a more youthful appearance.

The main goal of blepharoplasty is to improve the appearance of the eyes. This procedure can also improve vision if sagging skin on the upper eyelids is obstructing the patient’s vision.

Is Blepharoplasty Considered Cosmetic or Medically Necessary?

The answer to this question depends on the patient’s individual situation. In some cases, blepharoplasty may be deemed medically necessary if the drooping eyelids are obstructing vision. If this is the case, insurance may cover the procedure.

However, if the procedure is being done solely for cosmetic purposes, it is unlikely that insurance will cover the cost.

What are the Criteria for Medically Necessary Blepharoplasty?

For insurance to cover blepharoplasty, the procedure must be deemed medically necessary. The following are some of the criteria that may be considered for blepharoplasty to be considered medically necessary:.

Drooping eyelids that obstruct vision
Excess skin and fat that is causing functional impairment
Physical discomfort caused by sagging eyelids
Chronic eye infections caused by excess skin and folds on the eyelids

Will Insurance Cover Cosmetic Blepharoplasty?

If blepharoplasty is being performed solely for cosmetic reasons, it is highly unlikely that insurance will cover the cost. Cosmetic surgery is considered an elective procedure and is not deemed medically necessary.

Patients can still opt to have the procedure done, but they will be responsible for covering the cost of the surgery.

How Much Does Blepharoplasty Cost?

The cost of blepharoplasty can vary depending on several factors, including the surgeon’s experience, the complexity of the surgery, and the geographical location. On average, blepharoplasty can cost anywhere from $2,000 to $5,000 per eyelid.

If both the upper and lower lids are being done, the total cost could range from $4,000 to $10,000. It’s important to note that these costs do not include additional expenses such as anesthesia, facility fees, and post-surgery care.

What if Insurance Covers Some of the Cost?

If blepharoplasty is deemed medically necessary and insurance covers some of the cost, patients will still be responsible for any expenses that insurance does not cover.

Patients should speak with their insurance provider before scheduling the procedure to determine what their out-of-pocket expenses will be.

Is Blepharoplasty Safe?

Blepharoplasty is generally considered a safe procedure when done by an experienced and qualified surgeon. As with any surgery, there are potential risks and complications, such as bleeding, infection, and scarring.

These risks can be minimized by following all pre-operative and post-operative instructions from the surgeon.

Conclusion

Blepharoplasty is a popular cosmetic procedure that can provide significant improvements in both the appearance and function of the eyelids.

Whether insurance covers the cost of the procedure depends on whether it is deemed medically necessary or purely cosmetic. Patients should speak with their insurance provider and surgeon to determine what their out-of-pocket expenses will be.