Idaho Eyelid & Facial Palstic Surgery

Insurance Pay for Eyelid Lift Before and After Eyelid Surgery Before and After Eyelid Surgery

There are a number of considerations in determining whether an insurance company will cover the costs of an eyelid lift (blepharoplasty, ptosis repair, or both) in Boise, Idaho. The coverage varies from insurance company to insurance company. Some of the top considerations include:

  • External photographs – most insurers require photographs showing that the pupil is least partially covered by the eyelid
  • Measurement from the pupil to the upper eyelid
  • Visual field test – performed by one of our experienced medical assistants
  • Pre-authorization and supporting documentation from the clinic visit for insurance approval
  • List of daily living activities that are impacted by droopy lids (lifestyle complaint)

If the visual obstruction is significant enough, medical insurance will pay to have the skin removed to improve sight. This is considered a “functional” repair. When the amount of excess skin does not meet the strict criteria set by the insurance companies, the blepharoplasty is “cosmetic” and patients will need to pay out of pocket.The price of a blepharoplasty is dependent on the details of each procedure. Cost is based on factors such as total procedure time, techniques, and anesthesia (if necessary).

Sometimes, misunderstandings arise when a referring provider thinks a patient should qualify for a functional blepharoplasty, without first consulting and determining whether strict insurance requirements are met. Therefore, an in-person consultation with one of our physicians is required in Boise, Idaho.