Can pterygium surgery be a medical necessity?
If pterygium is interfering in your field of vision, the procedure may be covered as a “medically necessary” surgery. Before surgery, your ophthalmologist will perform a comprehensive eye examination. Photographs are often required by insurance companies before surgery to determine if the procedure is medically necessary. Final decision is made by your insurance carrier after reviewing your condition. Pingueculum surgery is not covered by insurance unless there is a medical necessity. Patients should check with their insurance carrier about their coverage. As a general rule, insurance does not cover cosmetic surgery.
