When performed for medical purposes, elective cosmetic surgery is not included. This implies that a “functional” blepharoplasty, which is only covered by medical insurance, is the only type of blepharoplasty that is covered.
If the skin around your eyelids sags and impairs your ability to perform daily tasks and affects your vision, blepharoplasty can be considered medically necessary. Often, insurance will cover the expenses out of pocket for this procedure.
At the clinic, you have the option to avail of exclusive financing or utilize a credit card, however, health care savings accounts cannot be used to assist with the expenses of a cosmetic blepharoplasty.
Out-of-Pocket Expenses With Blepharoplasty
The cost of blepharoplasty, on average, is over $3,000. Even when insurance covers the procedure, there are usually involved out-of-pocket expenses. This cost does not account for additional expenses related to the procedure, such as anesthesia and operating room facilities.
Insurance coverage often has a maximum amount or cap, which can exceed the procedure and coverage of that amount. Insurance coverage may only extend to the procedure itself and not to other associated costs. The amount you will pay for your blepharoplasty depends on your specific insurance coverage, including any copay fees and deductible amount.
To ensure that you have a clear understanding of all the potential upfront expenses and fees, it is important to confirm the details of your insurance coverage with your insurance provider, as well as obtain a detailed breakdown of the costs from your surgeon.
Insurance Coverage for Blepharoplasty
Blepharoplasty is one of the most common cosmetic procedures used to reduce signs of aging such as under-eye bags, wrinkles, sagging skin, and droopy eyelids.
It is possible to perform it on both the upper and lower eyelids. An eyelid lift can minimize the signs of aging and restore a more youthful appearance by reducing sagging skin and droopy eyelids. The procedure involves removing excess skin, fatty tissue, and muscle that can cause your eyelids to droop.
When performed for functional purposes, blepharoplasty is considered to be medically necessary and may be covered by insurance. However, if the purpose of the blepharoplasty is purely cosmetic, it is not covered by medical insurance as it is considered an elective procedure and the cost is not included.
When Blepharoplasty Is Covered
Typically, your peripheral vision, or vision at the sides, must be obstructed by the eyelid skin in order for a blepharoplasty to qualify for coverage by medical insurance.
Your sagging eyelids, along with photographic evidence and a statement about how your diminished field of vision are affecting an eye examination, have a significant impact on your daily life. The excessive drooping of the eyelid skin might obstruct your line of sight, making it difficult for you to carry out your usual activities.
Functional blepharoplasties are examples of when excess eyelid skin impairs your functional vision and can be medically necessary, therefore covered by most major medical insurance companies.
You will need to check directly with your provider to learn the specific details of your coverage, as they depend on the location, plan, and provider of the surgery, as well as the insurance company.
Help With Costs Beyond Insurance
There are other methods available to offset the overall cost, but if you want to get an eyelid lift for cosmetic purposes, your insurance will not cover it. Blepharoplasty can offer relief from irritation and result in a more youthful appearance, but it can also be expensive.
Procedure for paying for blepharoplasty cannot be done using your savings accounts or other health care spending accounts such as FSA or HSA. Blepharoplasty is a cosmetic procedure and cannot be covered for cosmetic reasons.
Another option for making the payment process easier is through the availability of payment plans and financing options, which many clinics offer either through the clinic itself or the surgery center.
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