There are specific measurements to determine when eye lid surgery is covered by Medicare.

Medicare Eye Lid Surgery

Sometimes as we age our eyelids start to sag making us think surgery may be required, and you may wonder if medicare eye lid surgery is appropriate.

For many people a sagging or drooping eyelid can obstruct the view or cause eyelashes to hang in way of your view. A heavy eyelid can also cause fatigue if you need to raise the eyebrows to improve your vision. In cases where vision is obstructed, (the proper term is functionally disturbing) Medicare and most insurance companies will cover the cost of eyelid surgery.

There is a specific measurement requirement before Medicare will approve the procedure. See your Doctor or Optometrist for the specifics. We believe the allowance is 12 degrees of the upper field of vision being blocked, or if the eyelid hangs down within 2.5 millimeters of the mid-pupil.

Blepharoplasty

The procedure (called upper lid blepharoplasty) removes excess skin, muscle, and fatty tissues from the upper lid under local anesthesia. This eliminates loose overhanging eyelid tissue. Some clinics are set up for day surgery procedure, but it may need to be done at your local hospital if a specialist is not nearby. Stitches close the cut and are removed in about 7 days. Swelling and brusing is common for up to two weeks.

Entropion And Ectropion

If the upper lids are sagging, there is a chance the lower lids can also sag. When this happens one of two problems will manifest. The lower eyelid will either turn inward making the lashes touch your eye, or fall outward away from the eye, leaving an uncomfortable gap. Both of these problems are considered functional problems and are covered by Medicare and most insurance companies.

Ptosis

Another condition which is separate from sagging eyelid skin is ptosis. The muscle used to raise your eyelid sometimes loses its hold on the lid, letting it fall. Repairing this condition requires tightening the eyelid muscle deep in the upper lid. In some cases this procedure is combined with blepharoplasty if both conditions are present.

If you feel you may be a candidate for medicare eye lid surgery, see your Doctor about the specifics to see if your condition qualifies for health insurance coverage.