Will Insurance Pay For My Brow Bone Reduction And Browlift?
Q: Dr. Eppley, It has been determined that I suffer from brow ptosis by my general doctor, he had recommended orbital rim contouring and a browlift to alleviate the issue and prevent it from happening in the future. I have also checked with my insurance company and they have stated that both procedures would be covered if deemed medically needed by the surgeon of my choice. I would love to be able to submit pictures if needed to assist you in diagnosing brow tosis on your own and would love to hear feedback. I was hoping it would be possible to request that the brow bone can be shaven to a more feminine contour. Please let me know if you are interested in helping me pursue treatment and are able to accept insurance or if we need to make an exception!
A: While there is no question that brow contouring can be done to create a more feminine appearance with or without a browlift, the issue of potential insurance coverage for it is almost certainly not. It is important to understand that when a patient calls up their insurance company, the standard unqualified answer is always ‘if your doctor says there is a medical reason for it, it will be covered’. Unfortunately that person and the section of the insurance company that they work for has nothing to with the department that actually approves the surgery and issues payment for it. That is the Predetermination section and they are tasked with determining whether there is any medical reason for the surgery. The only medical reason for a browlift is upper visual field obstruction and this must be substantiated with a visual field test. This must accompany a predetermination letter on which they will pass judgment about medical coverage. If they deem it is medically necessary based on the evidence, a browlift may be approved as a medical procedure. Any orbital rim/brow bone reduction/shaving never has a medical reason for it being done and is always deemed a cosmetic procedure.
Dr. Barry Eppley