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Does Medicare Cover Eyelid Surgery?

Christian Worstell by Christian Worstell    |    Published Oct 03, 2019    |    Reviewed by John Krahnert

Medicare does not typically cover cosmetic surgery such as eyelid surgerybut you may be in luck if the procedure is considered medically necessary by a doctor.

If vision is not impaired, the surgery is considered cosmetic and does not meet Medicare’s criteria for coverage. Medicare will only cover your surgery if you have:

  • Physical signs of upper eyelid skin excess
  • Proof of a minimum of 12 degrees (or 30 percent) of visual field obstruction as demonstrated on a visual field test (performed by an ophthalmologist)
  • Documentation (preoperative photographs) of a visual problem as described by the patient
  • A reviewing physician’s recommendation

does medicare cover eyelid surgery

Understanding Eyelid Surgery

As we age, changes occur in various parts of our eyes. Droopy eyelids (medically referred to as ptosis or blepharoptosis) can cause vision complications and may even signify a more serious medical problem. Eyelid surgery (or blepharoplasty) can be performed on the upper or lower lids to correct functional issues.

Out-of-Pocket Costs

Even if Medicare covers your eyelid surgery, you may still be responsible for paying certain out-of-pocket costs, such as deductibles, copayments and coinsurance.

 

Medicare Supplement Insurance can help cover your out-of-pocket eyelid surgery costs.

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