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When Does Insurance Cover Eyelid Surgery?

Plastic surgery procedures that are undergone for purely cosmetic purposes are not generally covered by health insurance. Insurance companies will usually pay for reconstructive surgery to repair abnormalities caused by congenital defects, trauma, or disease. However, if a procedure is performed in order to restore function and a normal appearance, insurance may cover the cost.

Eyelid surgery, technically called “blepharoplasty,” is a procedure that removes excess skin and fatty deposits from the upper eyelids, lower eyelids, or both. Dr. Wise uses a technique that results in the upper eyelid incisions hidden within the natural crease of the lid, and the lower lid incisions are made within the lower eyelid so there are no visible scars.

Closeup of an eye before, with the removed area highlighted, and after eyelid surgery

Insurance companies do not generally cover the lower eyelid blepharoplasty, but upper blepharoplasty is usually covered if an examination by an ophthalmologist determines that droopiness of the upper eyelid impairs vision. This qualifies the surgery as necessary to restore function to the eye, and the improved appearance of the eye is an added benefit. You may click here for more information on the American Society of Plastic Surgeons‘ recommended insurance coverage criteria for blepharoplasty. 

The cost of blepharoplasty is among the lowest of all facial cosmetic surgeries, so even if insurance only covers the upper eyelid surgery, most patients choose to undergo lower blepharoplasty as well. According to the American Society of Plastic Surgeons, the average surgeon fee for eyelid surgery varies, and the entire cost of surgery depends on the technique used and other factors, such as facility fees and region of the country where the surgery is performed. When it comes to plastic surgery, you get what you pay for, and cutting corners for cheaper surgery can have serious repercussions.

Dr. Wise is a face and neck specialist and has performed thousands of eyelid lifts. If you’re interested in blepharoplasty or any other plastic surgery procedure, please contact the practice of facial plastic and reconstructive surgeon Dr. Jeffrey B. Wise. Please fill out our online contact form or call 973-658-4019 today to schedule an appointment.

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