Labiaplasty is a surgical procedure that reduces, reshapes and reconstructs the labia minora (inner labia) and labia majora (outer labia) of the vulva. It is often recommended for medical reasons, such as to improve urinary incontinence, comfort or sexual function, but it can also be done for cosmetic reasons. In some cases, labiaplasty may be covered by insurance, but there are certain criteria that must be met in order for coverage to be granted.
How Insurance Companies Determine Coverage
In general, insurance companies will determine coverage for labiaplasty based on the medical necessity of the procedure. A doctor will usually make the decision to cover the procedure. He or she will decide if the procedure is necessary and medically necessary to improve a patient’s health or well-being. However, there are certain criteria that must be met in order for insurance companies to approve coverage for labiaplasty.
Criteria for Coverage
In order for insurance companies to approve coverage for labiaplasty, the patient must meet certain criteria. The criteria include:
- The labiaplasty must be performed by a board-certified plastic or reconstructive surgeon.
- The patient must have a medical necessity for the labiaplasty, such as urinary incontinence, sexual dysfunction or discomfort.
- The procedure must be pre-approved by the patient’s insurance company.
- The patient must have a written referral from their primary care physician.
- The patient must have a detailed treatment plan.
- The patient must have pre- and post-operative photos.
- The patient must follow all pre- and post-operative instructions.
- The patient must agree to follow-up visits with their physician.
- The patient must not have any contraindications to the procedure.
Costs of Labiaplasty with Insurance
If the patient meets all the requirements and the insurance company approves the procedure, the patient may be responsible for a portion of the cost of the surgery. This could include a co-payment, co-insurance, or a deductible. The amount the patient is responsible for will depend on the patient’s insurance plan.
Labiaplasty is a surgical procedure that reduces, reshapes and reconstructs the labia minora and labia majora of the vulva. It can be done for medical reasons, such as to improve urinary incontinence, sexual function or comfort, or for cosmetic reasons. In some cases, insurance companies may cover labiaplasty if the patient meets certain criteria and the procedure is deemed medically necessary. The patient may be responsible for a portion of the cost of the labiaplasty, depending on the patient’s insurance plan. You can also read our other articles in the Health category.