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February 4, 2024

When Is Labiaplasty Covered By Insurance?

Written by: Dr. Dahlia Rice. Posted in: Blog

is labiaplasty covered by insurance

Labiaplasty is a cosmetic surgery that works by reshaping or resizing the labia majora or the labia minora. It’s a type of vaginal rejuvenation that only requires local anesthesia for the vaginal lips, and the medical reasons behind it vary.

Many women opt to have the surgical procedure done to address common concerns regarding their labia minora and majora. These concerns include alleviating physical discomfort as well as enhancing the appearance of their vaginal area in addition to their sexual pleasure. While the ladder is completely optional, the former is often necessary.

Of course, one of the greatest concerns is the labiaplasty cost. That’s why many women whose doctors agree that the procedure is necessary find themselves asking the same question: Is labiaplasty covered by insurance?

Is Labiaplasty Covered By Insurance?

The short answer to the question is very rarely. Health insurance providers don’t typically cover the procedure because most patients seeking to reduce the size and excess tissue of their labia minora and labia majora are elective and performed under local anesthesia.

This makes it a cosmetic procedure and cosmetic surgery procedures aren’t considered to be medically necessary — and, therefore, labiaplasty insurance coverage is not applicable.
However, there are plenty of labiaplasty benefits for patients who require the procedure due to issues that are directly caused by the excess skin surrounding the vaginal opening, such as an enlarged labia.

These issues typically include:

  • Itching
  • Chaffing
  • Swelling
  • General discomfort
  • Bacterial infections
  • Yeast infections
  • Urinary tract infections (UTIs)

These are issues that can encroach on one’s daily life, which is what usually tips the scales into insurance coverage territory. Unfortunately, even if a patient feels that a labia reduction is medically necessary, it’s next to impossible to get insurance to pay for cosmetic surgeries.

Can Labiaplasty Ever Be Deemed Medically Necessary?

There are some rare cases in which an insurance company will agree to cover plastic surgeries such as labiaplasty surgery. These instances involve insurance providers agreeing that the labiaplasty is a reconstructive surgery rather than one of the many cosmetic procedures that most women want to address aesthetic concerns.
Reconstructive plastic surgery is different from cosmetic surgery in that it’s meant to return an individual’s body or face to its normal appearance or function. While this is technically the case with vaginal rejuvenation procedures, like labiaplasty, the reasoning behind vaginal rejuvenation is what matters the most.

In terms of labiaplasty being deemed medically necessary, you would have to have proof (medical records) of the following provable health issues:

  • Chronic pain, itching, and discomfort in the area
  • Consistent chronic urinary tract infections
  • Chronic discharge
  • Chronic rashes
  • Difficulty with urination

Essentially, to get your labiaplasty covered by your insurance as a reconstructive surgery rather than a cosmetic surgery, you’d have to prove that it’s not just an optional vaginal rejuvenation procedure. For example, you would need to have a medical need to correct an enlarged labia that would cause the above issues.

To do this, you would have to have a history of seeing your primary physician and specialists regarding these issues. This could include visits to your OBYGN, treatment for kidney infections or UTIs, chronic pain, and even seeing specialists regarding difficulty having sexual intercourse.

How to Pay For Labiaplasty Surgery When Health Insurance Providers Won’t

Even if you have medical records as proof, it still may not be enough to get your insurance to pay the plastic surgeons to perform a labia reduction. This means you’ll have to sift through your financial options to ensure you can afford to undergo labiaplasty.

Many women turn to these additional resources when sorting through their financial options:

when is labiaplasty covered by insuranceCareCredit

CareCredit is a credit card that’s specific to medical necessities. The company won’t ask what you’re planning to use it for, as it can only be used for medical reasons. This includes everything from regular doctor visits to reconstructive surgeries and even pet care.

Your credit score and history will determine the amount of credit you’re eligible for with CareCredit. The company also typically runs interest-free offers if you use your card during a certain time, which can alleviate your financial burden down the road.

Personal Credit Cards

Fortunately, labiaplasty isn’t an overly expensive procedure. If you have good credit and good interest rates, using your personal credit card is often an excellent option, as it usually involves smaller monthly payments.

Ask About a Payment Plan

Many plastic surgeons offer special financing options to help patients get the plastic surgery they need, even for cosmetic reasons. Speak with your plastic surgeon to discuss your financing options to see what they can offer you when your health insurance fails you.

Labiaplasty Cost and Insurance Coverage FAQs

How much is labiaplasty?

Labiaplasty typically costs between $3,000 and $6,500 — sometimes more. The average cost of labiaplasty is $3,453, but this doesn’t include the cost of anesthesia, operating room facility costs, and other related expenses.

The only way to know what your total costs will be for the reconstructive surgery is to speak with your plastic surgeon directly.

How can I convince my insurance company to cover labiaplasty?

If you want to improve your chances of getting insurance to cover labiaplasty, you’ll need to have medical proof that you need the surgery for medical reasons and not simply for your physical appearance and self esteem.

The best thing you can do is to call your health insurance provider directly to discuss your specific plan and your reasons for having to undergo labiaplasty. While you may not be eligible for partial or full coverage for the procedure at first, they may help you outline the steps to take to get the approval you need.

How do I talk to my doctor about a labiaplasty recommendation for my insurance provider?

Speaking with your doctor can be embarrassing and uncomfortable when it comes to having issues with your labia. However, it’s a necessary step in determining the next steps and getting the right referrals to other specialists who can help pile on the proof that the procedure is necessary.

If you already know that your discomfort and chronic issues require labiaplasty, be sure to let your doctor know your concerns regarding insurance coverage. They’ll help you build your documentation for the best possible outcome when it comes to your health insurance.

Will Your Insurance Cover Labiaplasty?

The only way to tell if your insurance will cover labiaplasty surgery is by speaking with them directly and speaking with your primary care physician to prove that it’s not for cosmetic reasons.

Dr. Dahlia Rice has helped many patients determine their eligibility for insurance to cover the procedure.

Schedule your consultation today to get started with us at DMR Aesthetics Chicago !



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