I am interested in having eyelid surgery, will it be covered by Medicare?

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I am interested in having eyelid surgery, will it be covered by Medicare?

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Laith Barnouti Avatar

Laith Barnouti

NSW

Laith Barnouti

3 Answers

Hello Claudia Many thanks for the email. Medicare will no longer cover cosmetic eyelid surgery. I will be delighted to look after you and give you beautiful results Management plan: eyelid surgery to discuss details on the day of consultation. Fasting time before surgery: 6 hours prior Surgery. No food, No water. Time off work: 5-7 days Total cost upper eyelid is $3,500. Total cost lower eyelid is $5,900. Video of the procedure: https://www.youtube.com/watch?v=peYJNBvmKc4 Photo gallery: https://www.plasticsurgery-sydney.com.au/before-after-photos-plastic-surgery/eye-bags-lift/ For Finance and comfortable payment plans: http://www.plasticsurgery-sydney.com.au/financing/ How to proceed: Broadway and Chatswood Clinic: Please call 1300 002 006 or 02-9561 0222 to book in for consultation. For Parramatta Clinic: Please call 02 9633 2423 or 1300 770 660 to book in for consultation. During the consultation I will have the opportunity to examine you and take you through the recommended procedure in details. You will have the opportunity to ask questions and make an informed decision if you wish to proceed further. Consultation fees: The consultation fees is $200. Get a doctor referral if you want to claim $74-$110 from Medicare and/or private health fund. I look forward to seeing you in person Sincerely Dr Barnouti Specialist Plastic Surgeon For booking: 02- 9561 0222 or 1300 002 006 Website: http://www.plasticsurgery-sydney.com.au/
Jack Zoumaras Avatar

Jack Zoumaras

NSW

Jack Zoumaras

3 Answers

Eyelid surgery is aesthetic plastic surgery and does not attract medicare rebates in most circumstances. If however you have loose skin that touches the upper eyelash and interferes with vision then a Medicare rebate is available. The end result of surgery is to Open your eyes.
Mark Magnusson Avatar

Mark Magnusson

QLD

Mark Magnusson

1 Answers

Hi Claudia, Thank you for taking the time to post a question on ask ASAPS. As you will have read, Medicare has changed the criteria for item numbers with respect to upper eyelid surgery. There is still an item number if the eyelid itself is droopy (ptosis: the upper lid margin is dropping across the coloured part of your eye) and if the skin of the upper eyelid is dropping over the eyelid margin and interfering with your visual fields. The reason for assistance in both of these conditions is that the eyelids are interfering with vision and this is a medical concern. When this interference with vision is due to the skin of your upper lid this now has to be documented by an optometrist to support your Medicare claim. The important aspect of having your visual fields assessed is that many of us raise our eyebrows to assist with vision. Your visual fields should be assessed with a relaxed brow so that the true extent of the problem can be accurately documented. Medicare assistance due to a visual field deficit is common at older ages and very uncommon in younger people unless it is due to eyelid ptosis. Medicare assistance if it applies will give you some money towards your surgery and if you have health insurance that may also provide additional support and pay for hospital costs if your level of cover supports this. It is very uncommon for lower eyelid surgery to achieve benefits from Medicare but there are isolated indications. Eyelid surgery is a very common procedure performed by specialist plastic surgeons. I hope the information you receive will be helpful. Good luck, Mark Magnusson Toowoomba and Gold Coast, Qld
John Newton Avatar

John Newton

NSW

John Newton

9 Answers

Hi Claudia Eyelid surgery is only covered by Medicare if it is done for a medical reason and not for a purely cosmetic reason. In the upper lid, the acceptable reason is reduction of your vision. This can be because of excess skin sitting down on your lashes ( Blephorochalasia ) or it can be because your eyelid itself does not open enough ( Ptosis ). Having your "visual fields" tested by an ophthalmologist is the best way to test for this, But be aware not to raise your brows when you do the test. In the lower lid, surgery is only rebatable if your lower lid is lose. It can roll out or not sit properly on your eyeball. Surgery for "fat bags" is generally not rebatable. A qualified specialist plastic surgeon can talk all of this over with you and not only sort any medical eyelid problem for you, but optimize the cosmetic appearance of your eyes for you. Best wishes, John Newton