Blepharoplasty (Eye Lid Surgery), Medicare and Insurance Coverage – Is It Fair?

Loss of vision as we age is probably one of the conditions everyone will face eventually. Vision is impaired as we age not only because of eyesight but for some patients also due to droopy eyelids. As the laxity of the skin on the eyelids becomes a greater issue with aging the eyelid skin can become so droopy that patients cannot see clearly. Unfortunately the body compensates for this and patients lift their brow eventually add habit without ever realizing that they cannot see well. Dr. Seify treats patients who have excessive loose skin on their upper eyelids. The procedure is called blepharoplasty. A small ellipse of skin is removed from the upper eyelid in the crease. The incision is sutured and well hidden in the crease. This lifts the eyelid and allows the patient to have better vision. A side benefit of the procedure is that the eyes have a much more youthful appearance once the loose skin is removed. If the vision is severely impaired for the patient there is a chance that the procedure could be covered financially by insurance or Medicare. Recently private advocacy groups have published some negative reports regarding the coverage of blepharoplasty by Medicare and or private insurance. In their published reports they have surmised that a majority of patients seeking blepharoplasty are really cosmetic cases just trying to take advantage of Medicare or private insurance. While it is understandable that an outside group may believe that plastic surgeons would falsify necessary information to have payment covered through Medicare or private insurance; the reality is that most plastic surgeons are committed to following necessary guidelines for submitting proper claims to either Medicare or private insurance. It is important for patients to understand that submitting their blepharoplasty claim to insurance is not something they should be ashamed of. If the claim falls within the guidelines of the insurer whether it is Medicare or private insurance then the patient has passed the necessary requirements and is entitled to have the procedure covered. Dr. Seify will submit claims for patients when he believes there blepharoplasty should be covered. Patient should be prepared to provide payment should be insurance or Medicare be unwilling to deem the blepharoplasty as necessary. Blepharoplasty is an excellent solution for patients who are living with compromised peripheral vision. The cosmetic aspect is a welcome to benefit. Patients who are considering blepharoplasty are encouraged to contact Dr. Seify and schedule a consultation.

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