How To Get Insurance To Pay For Eyelid Surgery?

Helen Skeates
Helen Skeates
10 min read

Obtaining insurance coverage for eyelid surgery can be a difficult task. In the event of an accident, or if you need to undergo surgery, insurance can be extremely beneficial. Blepharoplasty, or eyelid surgery, is becoming increasingly popular in the beauty sector, but it can also help those who have trouble seeing.

Keep in mind that insurance companies will only pay for surgery if it is classified as reconstructive or treating a functional concern. As a result, don’t expect your employer to foot the bill for cosmetic surgery.

Regardless, you should talk to your eye doctor and your insurance representative about the costs. Learn more about this as you continue reading, so scroll down for yourself to know how you can get your insurance company to pay for your eyelid surgery.

What Is Functional Eyelid Surgery?

To improve one’s facial look, eyelid surgery is a standard procedure. The surgery reduces the appearance of aging by removing extra skin and fat from the upper eyelids. Puffy bags under the eyes can be reduced or eliminated with eyelid surgery by removing excess skin and tissue from the lower eyelids. Eyelid surgery conducted exclusively for aesthetic purposes is not covered by health insurance because it is deemed elective.

Eyelid Surgery - Iranian Society of Plastic and Aesthetic Surgeons

If eyelid surgery is deemed medically essential, it may be reimbursed by health insurance. The thick skin that hangs over the lash line and obstructs the line of sight is removed during functional eyelid surgery. Daily activities like driving, reading, and texting might be complicated if your vision is hampered by extra skin on your upper eyelids that hangs down.

In order to discover whether or not eyelid surgery is covered by your insurance, you’ll typically need to provide documentation such as a vision test. A board-certified eye doctor, such as an oculoplastic surgeon, must conduct the vision test. Patients who have vision problems will have their condition documented by the surgeon and sent to their insurance company for review. Depending on the patient’s unique insurance plan, the insurance company may cover all or part of the cost of eyelid surgery.

Is Your Vision Significantly Affected?

Sagging upper eyelids might impair your vision to the point that it becomes difficult to carry out daily tasks. As a result, eyelid surgery may qualify as medically required and so be covered by insurance.

A doctor’s note and high-resolution images of your eyes may be required to verify that blepharoplasty is necessary to improve your vision and quality of life.

Do You Have Another Related Condition?

The cost of your eyelid surgery may be covered by your insurance if your eyelid sagging is caused by a medical condition like thyroid eye disease or chronic eye dermatitis.

Check with Your Cosmetic Surgeon

You can discover out if your surgery is covered by your health insurance plan by speaking with your cosmetic surgeon and then your insurance provider.

The majority of cosmetic surgeons will offer financing options to assist make eyelid surgery as reasonable as possible, even if it is not covered by insurance.

How much does eyelid surgery cost?

A cosmetic eyelid surgery in 2020 costs on average $4,120 according to the American Society of Plastic Surgeons (ASPS). Anesthesia, operating room facilities, and other related costs are not included in this average cost. If you have any questions, please contact your cosmetic surgeon’s office for clarification.

The cost of cosmetic eyelid surgery is determined by the surgeon’s level of experience, the treatment performed, and the location of the practice.

Eyelid Surgery

Be careful to inquire about payment options for cosmetic eyelid surgery from your plastic surgeon.

Eyelid surgery costs may include:

  • Fee for a surgeon
  • Hospitals and surgery centers are expensive.
  • The cost of anesthesia
  • Medication prescriptions
  • Tests of health

Choosing an eyelid surgery board-certified plastic surgeon in your area is a vital decision, but so is the surgeon’s experience and your comfort level with him or her.

Eyelid surgery and health insurance

Cosmetic surgery and its aftereffects are typically not covered by most health insurance plans.

To remove the excess skin covering the eyelashes, an eyelid operation may be covered by insurance. Look over your insurance carefully.

Will An Insurance Pay For Eyelid Surgery?

They would, if it wasn’t for just aesthetic reasons. In order to get insurance to cover eyelid surgery, how do you do it? First, as previously indicated, if your eyelid needs to be repaired or reconstructed to improve your vision, your insurance company may cover the cost of surgery.

Eyelid dysfunctions such as blepharochalasis, dermatochalasis, ptosis, bulging orbital fat, narrowing of the visual field, and floppy eyelid syndrome are often tolerated.

Now, in order to get your insurance to cover your eyelid surgery:

#1. Ask your optometrist to document the surgery as medically necessary

Request documentation from your eye doctor or optometrist to verify that surgery is medically necessary. Schedule an appointment. It’s imperative that your doctor identify the issue with your eyelids that necessitates blepharoplasty if:

  • Inflammation of the body (swelling)
  • Ptosis of the brows/eyelids
  • Blepharochalasis
  • Inflammation of the cornea (keratitis)
  • Inflammation of the conjunctiva
  • Dermatochalasis
  • Expansion of the orbital muscles of the eye (hypertrophy)
  • Extrusion of fat from the orbits
  • Defects in the visual field
  • There are malar festoons everywhere (bags)
  • Agony-in-the-face (poor eyelid closure)

As a treatment for these problems, surgery is required, which insurance will fund. So, go on to the next advice to make certain your organization is protected. For the time being, make sure your eyes are as comfy as possible by using an eye pillow. Make an effort to learn about eye pillows if you don’t already!

#2. Prepare visual proof of your condition

In addition to the paperwork, images will help you prove that you require surgery. Scheduling an appointment to see a surgeon will allow you to get a better idea of what’s wrong and how to fix it. That’s crucial since most insurance companies need patients to sign a permission form if they want photos.

#3. Present a pre-operation diagnostic test result

Finally, the insurance company that will foot the bill for the operation will require your doctor’s pre-operative diagnostic test, which will show whether or not you need corrective surgery. Among the items on the exam are:

  • It’s Schirmer’s test.
  • CBC/SMA-7
  • Studies on bleeding and clotting
  • Examination of the heart

If you follow these guidelines, your insurance company will pay for your eyelid surgery. However, as previously stated, insurance companies will only pay for surgeries that are deemed medically necessary. Regardless, here are some frequently asked questions about eyelid surgery that you may want to know the answer to.


People who want to get insurance coverage for their operation ask these questions:

#1. Will insurance pay for an eye lift?

Most insurance companies demand a visual test to establish if the eyelid surgery is necessary to improve your vision, so you may be able to get it covered if you have confirmation of that. A board-certified plastic surgeon or an eye specialist should be able to carry out the necessary visual exam. In any case, you might be curious as to which vision care providers accept Davis Vision insurance.

#2. Will the insurance company, pays for my droopy eyelid surgery?

In other words, even if a procedure is medically required, your insurance company won’t cover it because they care about your health. The firm will pay for eyelid surgery if you have a vision test that shows you have a problem that necessitates it.

#3. How much does blepharoplasty cost?

As reported by the American Society of Plastic Surgeons, the average cost of blepharoplasty was $3,282 in 2019. (ASPS). However, the price can vary based on the extent of the surgery and your health, sometimes in terms of quality. As a result, the price is often in the $1,000-$10,000 area, however this is subject to change.

Eyelid Surgery Fort Myers | Eyelid Lift Naples | Frantz Cosmetic


It’s common for people to get procedures like blepharoplasty to improve their appearance, rather than because of a medical issue. Insurance companies will not reimburse your bills if this is the case. You will have to put money aside on your own.

We have come to the end of our article on “How to get insurance to pay for eyelid surgery?” We sincerely hope that you have gained a great deal from reading this essay and that you are now able to answer your quest’s question. As a result, to learn more about insurance, you can check out this article, “What is exposure insurance?” Thanks!

Helen Skeates

Helen Skeates

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