Does Health Insurance Cover Blepharoplasty?

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   Marlin McKelvy

   President, Consumer Directed Benefit Solutions, Memphis, Tennessee

   As this procedure is designed to remove or reduce puffiness, droopiness, wrinkles and discoloration around the eyes it falls squarely in the "cosmetic surgery" category.  Health insurance plans do not cover cosmetic surgeries for the sole purpose of enhancing a person's appearance.  So, I would say that about 99% of the time this would not be a covered procedure under your health insurance.  While I have never actually heard of it being covered in my 30 years in the industry, there may be very extreme cases where a person's vision is being impaired or blocked by this condition.  That is the only circumstance I can think of where a case for medical necessity could be made for this procedure but your doctor would have to present some very definitive supporting documentation to your insurance carrier for them to even consider it.  I think that if you are considering having this procedure performed you'll have to be prepared to pay for it yourself just like Paul McCartney and Brad Pitt did.

   Answered on July 2, 2014

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