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Why Eyelid Surgery Could Be Medically Necessary

While eyelid surgery, also known as blepharoplasty, can do wonders for your appearance, it’s not just cosmetic. Blepharoplasty can be covered by insurance as a medically necessary procedure in certain cases. In this post, we’ll discuss when eyelid surgery is deemed medically necessary along with other factors that you should consider.

Impaired Vision = Medically Necessary

Eyelid surgery can be done to correct sagging and drooping of the upper or lower eyelid that can affect your vision, and by association, your quality of life. It’s not uncommon for eyelid surgery to be done as a medically necessary procedure when the affected eyelids are blocking the person’s field of vision. It is almost always the upper eyelid causing the obstruction, so medically necessary lower eyelid surgery is quite rare.

Function vs. Appearance

One of the easiest ways to tell if your eyelid surgery will be deemed medically necessary is to ask yourself: “Why do I want eyelid surgery?” If the answer is only to help you look better, then the surgery is elective and not medically necessary. If the answer is to improve your vision, along with helping you look better, then it’s likely that your insurance will cover the surgery as medically necessary.

Required Documentation

Your insurance company isn’t just going to take your doctor’s word for it that your need for surgery is medically necessary; they’re going to want proof. Once you’ve told your doctor about your desire for eyelid surgery, they’ll do a physical examination and refer you to an eye specialist for a visual field test. Notes from both doctors and your test results will be submitted with the pre-authorization request for the surgery to your insurance company. If all goes well, the insurance company with approve the procedure and you’ll be on your way to better vision and a more youthful appearance.

Don’t Forget the Brows

For patients who already have a heavy or low eyebrow, upper eyelid surgery can pull it down even more. This is why we often recommend a brow lift to be done along with blepharoplasty to give you the most natural result possible. If blepharoplasty alone will leave your brow so low that you would look unnatural, your insurance company will likely deem the brow lift medically necessary as well.

Eyelid Surgery in Tampa Bay

If your upper eyelids are drooping and affecting your field of vision, contact Justin J. Older’s Eyelid Institute in Tampa. Dr. Older has helped countless patients improve their vision and their appearance with eyelid surgery, brow lifts, and more. Call (813) 971-3846 to schedule your consultation today!

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Tampa – Main Office
5379 Primrose Lake Cir
Tampa, FL 33647
(Inside the office of The Bowman Institute for Dermatologic Surgery)
Phone: (813) 971-3846

St. Petersburg
6950 Central Ave
St. Petersburg, FL 33707
(Inside the office of The Pasadena Eye Center)
727-342-3004 (also after hours)

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Contact Us

Phone: (813) 971-3846
(727) 342-3004 (also after hours)

Office Hours:
Mon - Fri: 8am - 5pm

5379 Primrose Lake Cir
Tampa, FL 33647
(Inside the office of The Bowman Institute for Dermatologic Surgery)
Phone: (813) 971-3846

6950 Central Ave
St. Petersburg, FL 33707
(Inside the office of The Pasadena Eye Center)
(727) 342-3004 (also after hours)

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