Upper Blepharoplasty in Appleton: How to Get Eyelid Surgery Covered by Insurance

Upper blepharoplasty, commonly known as upper eyelid surgery, is one of the most frequently performed procedures at Appleton Plastic Surgery Center. While many patients pursue this surgery for cosmetic enhancement, upper blepharoplasty can also be medically necessary—and in those cases, it may be covered by insurance.

Understanding the difference between cosmetic and functional eyelid surgery is essential if you are hoping to receive insurance coverage.

What Is Upper Blepharoplasty?

Upper blepharoplasty is a surgical procedure that removes excess skin—and sometimes fat—from the upper eyelids. Aging, genetics, and gravity can cause the eyelids to droop over time, leading to a tired appearance or obstruction of vision.

When excess upper eyelid skin interferes with your field of vision, the procedure may qualify as functional rather than cosmetic.

When Is Upper Blepharoplasty Covered by Insurance?

Insurance companies may cover upper blepharoplasty when it is considered medically necessary. To qualify, patients typically must demonstrate:

• Documented visual obstruction

• Functional impairment such as reduced peripheral vision

• Objective test results confirming vision loss

Visual field testing is required to support insurance approval.

Visual Field Testing at Appleton Plastic Surgery Center

Appleton Plastic Surgery Center offers in-office visual field (VF) testing during your consultation appointment.

• Test cost: $100

• The visual field test is often not covered by insurance

• The test is required by insurance companies to determine eligibility for coverage

Despite being an out-of-pocket expense for many patients, this test is essential for insurance approval.

Why Insurance Often Does Not Cover the Visual Field Test

Many insurance providers consider the visual field test part of a surgical evaluation rather than a covered diagnostic service. Without this test, insurance approval for upper blepharoplasty is unlikely.

What Happens After the Visual Field Test?

1. Results are reviewed by your plastic surgeon

2. Clinical photos and documentation are submitted

3. Insurance determines coverage eligibility.

If approved, insurance may cover part or all of the functional portion of the surgery.

Schedule a Consultation at Appleton Plastic Surgery Center

If drooping upper eyelids affect your vision, upper blepharoplasty may be more than a cosmetic procedure. Schedule a consultation at Appleton Plastic Surgery Center to determine whether you qualify for insurance coverage.