Does Insurance Cover Ptosis?

Ptosis is a condition of the upper eyelid where the muscles and skin of that area begin to droop and sag to the point that they begin to obstruct a patient’s vision. So, does insurance cover ptosis?

Does Insurance Cover Ptosis?

Ptosis can range from a mere annoyance or aesthetic issue to one that has the potential to be more medically hazardous depending on its severity.

One question that’s always relevant for any procedure is whether or not it’s covered by one’s insurance. Whether or not it can make a difference towards whether you end up receiving treatment at all for your facial eyelid surgery.

A Ptosis Overview

Ptosis can take many forms in terms of how it expresses itself. Ranging from mild to severe, it generally expresses itself as drooping and sagging skin over the eyes.

Ptosis is generally treated through an Upper Blepharoplasty or upper eyelid surgery. During this procedure, a physician manipulates the skin and muscles surrounding this area of the eye to pull back the skin and eliminate the ptosis phenomenon.

Ptosis can begin to become more of a serious issue once it reaches the point where it obstructs a patient’s vision. At this point, daily activities such as driving or operating heavy machinery can become more difficult or impossible.

An Early Symptom of Aging

One of the first body parts to show the effects of aging is the eyelids. As the years go by, gravity begins to do its inevitable work, which facilitates a gradual drooping of the eyelids.

Because of this, the eyelids are frequently interpreted as signs of stress or aging, two characteristics that are regrettably viewed as drawbacks in our society.

In the long term, one can avoid a great deal of annoyance by avoiding the negative professional, personal, and emotional effects of this occurrence. Additionally, it helps you get ready to navigate life by putting you in the best possible position.

Making It a Medical Issue

For Ptosis treatment to be covered by insurance, this aforementioned level of severity is what is required to get insurance to cover treatment in most cases.

This is because the insurance agencies must be convinced that the issue is of medical concern on some level and not just an aesthetic issue that a patient wants to address.

Convincing insurance companies to pay out in these situations can sometimes be challenging. There’s a strong possibility that you’ll have to undergo several medical tests and provide a medical referral from your physician in order to acquire approval from insurance.

Proving Your Case

As stated before, in order to have insurance cover part of or your entire operation, you’ll have to prove that your ptosis is of a severity that it’s medically concerning.

The easiest way to do this is to display to your physician all of the ways that your condition interferes with your daily existence.

There are a number of ways that you can do this. Ranging from anecdotal evidence to reports from other authorities and people in your life.

Overall, you’ll have to assemble some evidence to make a convincing argument. The strongest case to be made in these types of situations is that of medical evidence.

If you’re able to provide your physician with some type of medical evidence that ptosis has interfered with your daily existence somehow, you’ll find yourself with a much stronger case.

Discussing Your Unique Situation

Prior to your operation, you’ll schedule a consultation with your physician. There you can discuss the unique ins and outs of your personal situation with ptosis.

During this consultation, you’ll discuss everything from your own medical history to the types of medications and supplements that you take.

All of this will feed into information that you can use in order to build a case that your ptosis is of medical concern. On top of this, it can help your physician stay informed of the best course of action to take regarding your personal case.

All in all, it’s a time for you to take stock of the information you need to more fully understand your personal situation. This can only benefit you as you move forward with your attempt to get insurance to cover the costs of your operation in general.

Southern California’s Ptosis Experts

If you’re suffering from the effects of medical-grade ptosis, then consider visiting our website in order to schedule a consultation to find out more about our facial eyelid surgery options. You’ll likely find out why OC Oculoplastic is considered one of Southern California’s best centers for ptosis surgery costs in Orange County.