Labiaplasty, also known as labia surgery, is reconstructive surgery or cosmetic surgery for the labia minora, to help them appear more flush or “tucked in” with the labia majora. This surgery is a type of vaginal rejuvenation. Although it may be performed in conjunction with vaginoplasty, the two procedures are different.
When it comes to labiaplasty cost concerns, patients often have questions regarding insurance. Specifically, women want to know if they can get labiaplasty covered by insurance and, if so, how to get labiaplasty covered by insurance. Commonly asked questions include:
- How much does labiaplasty surgery cost?
- Is a labiaplasty covered by insurance?
- Does an obgyn refer labiaplasty patients?
As a general rule, health insurance does not cover cosmetic procedures. Typically, insurance coverage is reserved for procedures that are deemed medically necessary. Rhinoplasty because of a deviated septum, for example, may be covered so that the insured can return to normal breathing. Breast augmentation is also sometimes covered after a mastectomy.
So, can you get a labiaplasty covered by insurance?
Sometimes. When the surgery is needed for medical reasons, then often, this procedure is covered. However, there’s more to unpack here, so we invite you to read on to get a better picture of what you can expect for your labiaplasty coverage.
Is Labiaplasty Covered by Insurance?
Labiaplasty is typically not covered by insurance unless the procedure is medically necessary.
Basically, insurance providers will evaluate your situation and the proposed procedure to determine if the latter will be “reconstructive” in nature or purely cosmetic. As a rule, health insurance does not cover cosmetic procedures, so your procedure will need to be deemed reconstructive if you want to get a “free labiaplasty” (one covered by insurance).
When Is Labiaplasty Considered Medically Necessary?
So, what qualifies you for a labiaplasty coverage?
Before diving into the specific ways labiaplasty may be covered, let’s go over the difference between reconstructive surgery and cosmetic surgery because this is what your insurance company will be focusing on.
Reconstructive plastic surgery (sometimes just called “plastic surgery” to delineate it from cosmetic surgery) is surgery that returns the patient’s face or body to its normal function and appearance. Let’s take a woman who’s undergone a mastectomy (breast removal), for example.
Women may undergo a mastectomy because they’ve been diagnosed with breast cancer or because they have a strong family history of breast cancer. In this case, insurance will often pay for reconstructive breast augmentation — or breast augmentation (implants) meant to return the patient’s breasts to their normal appearance.
On the other hand, insurance will not cover this same procedure for a woman who has not undergone a mastectomy and who, perhaps, desires breast augmentation because she wants to have larger breasts for aesthetic reasons.
In the case of the patient who underwent a mastectomy, her breast augmentation would be considered a reconstructive surgery (plastic surgery). For the patient who wanted larger breasts to improve her appearance, her breast augmentation would be considered a cosmetic surgery.
Only reconstructive surgery is covered by health insurance.
Ultimately, here is a list of the main reasons for medical insurance labiaplasty insurance coverage:
- Chronic pain, itching, and discomfort in and around the labia
- Persistent chronic urinary infections
- Chronic discharge or rashes
- Difficulty urinating
How to Document Your Medical Need for Labiaplasty
Women who have serious medical reasons for labiaplasty surgery will need to document their medical reasons so that they can get labiaplasty insurance coverage.
Basically, your medical records will need to show that you’ve been forced to see doctors or specialists to discuss labia-related issues in the past. Perhaps you’ve made appointments for kidney infections, trouble urinating, UTIs (urinary tract infections), chronic pain, or difficulty having sex.
Does Your Insurance Cover Labiaplasty?
In order to determine if your insurance company covers labiaplasty, you’ll need to call your provider directly. While most health insurance providers have online charts and outlines of what’s covered and what’s not under their plans, contacting them directly is always the best course of action when you need preauthorization.
Once you’re connected with a customer service representative, and they’ve got your plan pulled up, tell them about the reason(s) you’re looking to get labiaplasty. Remember that your provider will only offer full or partial coverage if you have a medical need for this procedure, so do not mention embarrassment or emotional discomfort if you’re looking for coverage.
Finally, keep in mind that labiaplasty is rarely covered by insurance. While this is not meant to discourage you, it’s important to understand so that you don’t expect and make plans assuming that your procedure will be paid for.
Consult With Dr. Ashley Steinberg
If you plan to undergo labiaplasty, it’s important to meet with a plastic surgeon first, before everything else, so that you can discuss your candidacy, the cost of surgery, and more. Female board-certified plastic surgeon Dr. Ashley Steinberg has extensive training in the correction of labia minora hypertrophy (large labia) in the Houston, TX area.
To learn more about labiaplasty and to find out if you qualify for labiaplasty insurance coverage, contact our office and book a consultation with Dr. Steinberg today.
References
https://www.plasticsurgery.org/news/blog/what-is-a-labiaplasty-and-what-does-it-involve
https://www.webmd.com/women/guide/vaginoplasty-and-labiaplasty-procedures
