Cosmetic Eye Surgery
Cosmetic eye surgery usually isn’t paid for by insurance companies. They figure you’re having the surgery done for reasons that are not medical only cosmetic. Therefore if isn’t medical, it isn’t their problem. But do they ever make exceptions?
There’s an eye lid surgery procedure that sometimes they will cover. If the skin of your eyelids droops so much that it affects your vision, it may be covered. It’s called Procedure 15823. To qualify for this eyelid surgery to be covered by insurance, you have to take a “visual field” test. This test will confirm whether the excess skin is causing vision problems. The test evaluates each eye. When you visit your ophthalmologist, the doctor will have you cover one eye and look into a box with the other eye. You push a button when you see a light. If you don’t see the light, then the ophthalmologist can conclude the excess skin which is hanging over your eye is causing you vision problems.
Your insurance carrier may cover the procedure because it’s more than cosmetic eye surgery because some people who have this condition have their vision obstructed both superiorly and laterally. This can cause problems while driving for instance. If the insurance carrier does approve the eye lid surgery, it will only pay for the upper lid to be done though. After the evaluation, a letter of prior authorization is sent for approval. The insurance carrier has to deem the procedure a medical necessity. If they so no, there is still hope though. You can always contact a good lawyer and litigate to make them pay for the procedure.
If you’re have drooping lids which are affecting your vision, contact your Miami eye specialists to see if they can help with your insurance paying for this procedure.