Is Labiaplasty Covered by Insurance?

Labiaplasty is rarely paid for by insurance coverage. This is because — for most patients who seek labiaplasty to reduce the size of their labia minora — the procedure is cosmetic. 

Certainly, some patients may feel uncomfortable about having enlarged labia. However, even though this is an understandable concern, the majority of health insurance providers will not see corrective labiaplasty as “medically necessary”.

Moreover, even if your desire for a New Jersey labiaplasty procedure is medically necessary in your eyes — perhaps because you have experienced pain and discomfort, itchiness, chafing, and other persistent symptoms — some insurance companies still may not cover the procedure simply as a matter of course. Although there are government-mandated surgeries that all insurance companies must cover, there are still many procedures that insurance companies vary on in terms of coverage.

Is Labiaplasty Covered by Insurance Ever?

Labiaplasty is a common surgery that shortens or adjusts the length and size of the inner labia. You may undergo this surgery with general or local anesthesia.

Many women consider a labiaplasty when troublesome symptoms such as pain, chafing, itching, and self-consciousness after childbirth start to encroach on their daily lives. These aren’t motivations only related to vanity, and for this reason, these patients often want to know will insurance cover labiaplasty. 

So, is labiaplasty covered? Unfortunately, even when the patient feels that labiaplasty is needed for medical reasons to improve their ailments, insurance companies do not routinely have labiaplasty covered. 

There may be rare cases in which an insurance company may have labiaplasty covered, but it tends to be categorized as a cosmetic surgical procedure. The average labiaplasty surgery is around $3,000 to $9,000 or sometimes more.

Because of this, the removal of excess tissue on the labia minora is seen as elective and not medically necessary. Of course, you should always check with your provider directly. You can simply call and ask, “Is labiaplasty covered under my plan?” You should get a direct answer.

Why Isn’t Labiaplasty Procedure Covered by Insurance?

Whenever insurance coverage companies evaluate a procedure, a medication, or another medical initiative, they consider whether it is “medically necessary”. This is their way of gauging procedures, medications, etc. so that they don’t end up paying for services that aren’t really mandatory.

Of course, this may feel very relative and subjective. To one person, a specific surgery may seem absolutely necessary, but to another person, it is totally unnecessary. 

This is the difficulty when it comes to plastic surgery and cosmetic surgery and the differences between these fields. Some procedures in this realm of medicine help individuals in fundamental and essential ways, and others are objectively cosmetic surgery procedures, performed for cosmetic reasons. Let’s dive into this a bit more.

What Does “Medically Necessary” Mean?

To help define what “medically necessary” means, let’s look at a few examples.

First, let’s say that a patient has painful gallstones. This is an acute medical issue that must be addressed immediately or the individual will suffer chronic symptoms that will worsen over time. This patient requires gallbladder removal surgery. The surgery is “medically necessary”.

Plastic surgeons will tell you that there is a wide range of procedures and treatments that may be deemed “medically necessary”. This category of medical treatment even includes some plastic surgeries. But here, we need to define the difference between plastic surgeries and cosmetic surgeries.

Plastic surgeries include all different types of cosmetic procedures as well as surgeries that are deemed “reconstructive”. For example, breast augmentation is a plastic surgery, and it can be “medically necessary” when the patient has gone through cancer and a mastectomy and needs to essentially reconstruct their breasts. In this case (after a mastectomy), health plans usually cover breast augmentation.

On the other hand, breast augmentation may be a cosmetic surgery when it is not performed because a patient’s been through breast cancer and a mastectomy, but because the patient simply wants larger breasts. 

There is nothing wrong with wanting larger breasts, but this is a cosmetic or aesthetic pursuit. Therefore, insurance is not going to cover this procedure for that patient.

What Procedures Are Covered by Insurance?

Basically, insurance coverage will include procedures that a patient needs to restore their body to normal function and appearance. Breast augmentation after a mastectomy, reconstructive surgery that is required after a severe hand injury, rhinoplasty because of breathing problems, excess skin that’s causing chronic pain and skin issues, and other absolutely necessary procedures may be covered by health insurance.

Of course, this all depends on your insurance company, the specific health plan you’ve chosen, and what plastic surgery procedure you are considering. If you want to know if a surgery will be covered by your health insurance plan, your best course of action is to contact your health insurance company directly.

How to Pay for Labiaplasty Surgery

When symptoms are such that enlarged labia are causing chronic symptoms for you, labiaplasty may be the answer. This procedure can shorten the length of the labia minora and improve your overall comfort and self-confidence.

Because insurance rarely provides coverage for this procedure, however, you may be wondering how you can pay for it. Many plastic surgeons will provide additional financing options. At our practice, we accept:

Credit Card Payments for Labiaplasty

Patients who are extremely interested in a plastic surgery but don’t have the liquid money to pay for their surgery out-of-pocket may pay with a credit card. The average labiaplasty price can be put on most credit cards.

At our practice, we accept all major credit cards, including MasterCard, American Express, Discover, and Visa. Of course, we also accept personal checks and cash. 

CareCredit to Pay for Labiaplasty

Many patients will qualify for CareCredit as well. Unlike health insurance, CareCredit specializes in helping patients undergo surgeries that are deemed elective. For example, this type of credit may help you pay for LASIK eye surgery — or plastic surgeries such as labiaplasty.

The great thing about this form of credit is that it offers short-term loans, and very low interest payment plans. There are no upfront fees, prepayment penalties, or other needless labiaplasty costs. You can simply pay off your procedure by making smaller monthly payments. Contact CareCredit directly for additional resources and information.

Questions and Answers

How to get insurance to cover a labiaplasty?

For labiaplasty to be eligible for insurance coverage, it must be determined as medically necessary by the individual’s healthcare provider. While you may wonder if labiaplasty insurance exists, ultimately the decision of whether or not your procedure will be covered comes down to your provider This determination may arise if the patient is undergoing considerable physical discomfort or pain due to the size or shape of their labia.

What qualifies you for a labiaplasty?

To qualify as a suitable candidate for labiaplasty surgery, women need to fulfill the following conditions: dissatisfaction with the size and/or shape of their labia major or labia minor, and experiencing discomfort or irritation due to excessively large labia major or labia minor.

Is labiaplasty ever medically necessary?

When the labia minora tissue is drawn or folded into the vaginal opening during sexual intercourse, labiaplasty is deemed medically necessary. Additionally, surplus labia tissue can lead to challenges in maintaining adequate hygiene and raises the risk of urinary tract infections in women.

How long is labiaplasty recovery?

What is the labiaplasty recovery timeline? It is a common question from patients. According to the ASPS, individuals usually regain the ability to return to work and normal activities within two weeks of the surgery. However, it is advised to abstain from sexual activity for a minimum of six weeks post-procedure. Swelling may persist for several weeks, and complete recovery may take up to six months.

Book Your Labiaplasty Consultation Today

While insurance companies may not deem labiaplasty as a medical need because it is primarily a cosmetic procedure and not reconstructive surgery, we know that enlarged labia can certainly cause serious problems. Some patients have even attributed it to chronic urinary tract infections or kidney infections.

If you would like to discuss your medical records, discuss what to expect before and after and candidacy for labiaplasty or talk about payment options for surgery, please contact our office today. We would be happy to schedule a consultation with you and get all of your questions answered. 

References

https://www.plasticsurgery.org/news/blog/what-is-a-labiaplasty-and-what-does-it-involve