Will Health Insurance Pay For Labiaplasty?

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   Marlin McKelvy

   President, Consumer Directed Benefit Solutions, Memphis, Tennessee

   As a general rule, Labiaplasty is considered a cosmetic procedure and therefore it is excluded from coverage for not meeting medical necessity requirements.  Are there situations where a Labiaplasty would meet the criteria for medical necessity and then be covered as any other covered condition?  Yes.  Some women experience issues that are best medically addressed using this procedure.  However, you should approach this kind of potential claim with the understanding that your insurance carrier's first instinct will be to see this as a cosmetic issue not a medical one, even if a cursory medical diagnosis is made.  Be prepared to truly demonstrate medical necessity and understand what your carrier's criteria for medical necessity are when you approach them on a procedure of this type.  It is a procedure that has grown in popularity as a cosmetic procedure and so attempts to camouflage the cosmetic procedure under a thin cover of medical necessity are hardly unheard of.

   Answered on May 20, 2014

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