According to research by the nonprofit news outlet Center for Public Integrity, vague rules and creative interpretation have allowed hundreds of thousands of 60-somethings to charge their eyelid lifts to Medicare.
The Center says the annual cost has now topped $80 million, mostly because of rules that allow the cosmetic procedure - usually disallowed by Medicare - to be considered a medical necessity for vision obstructed by droopy eyelids. Among the most active plastic surgeons, 11 of the top 20 billers are in Florida, and they include a South Florida doctor who collected for 22-hundred eyelid lifts in 2008. Elected representatives and Medicare activists have reacted to the story with outrage but many doctors say seniors do lose peripheral vision as aging eyelids begin to sag, and the youthful appearance the surgery provides is just a side effect, and not the purpose, of the procedure.