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Insurance Coverage and Electrolysis

Updated: Apr 18, 2023

Electrolysis is becoming significantly more accessible through insurance reimbursement! This is has been a huge step in the right direction for health and medical coverage to the LGBTQIA+ community. How does it work? Well, it does vary from insurance company to insurance company, but there are some basic consistencies throughout that we will share here. This applies to electrolysis that they consider "medically necessary", which is determined by medical professionals, but generally applies to:

1. Pre-Op genital electrolysis

-Most insurance companies reimburse pre-op electrolysis. It is medically necessary for the surgery in most instances. We have yet to see someone not receive reimbursement in this case.

-Clients often times need letter from surgeon stating that the hair removal is medically necessary, which they then use to receive pre authorization.

2. Clients with medically documented Gender Dysphoria

-Typically clients need medical documentation of history of gender dysphoria, a certain amount of time on hormones, and a pre-authorization from prescribing doctor, all of which are required by the insurance company, not us.

What we are able to help with:

  1. We provide information to the insured/insurer specific to our services (typical cost, length of sessions offered, basic electrolysis information) and then provide verification of actual services provided on a monthly basis for the insured to present to the insurer for reimbursement.

  2. We provide verification for reimbursement because we are not able to accept insurance ourselves directly.

  3. When it comes to authorization – we would be happy to provide any specific information that the insurer may request that we are able to provide, but we have not had much input with the authorization process, since we are not a medical office and do not provide diagnosis or patient assessments that being said the authorization typically comes from their prescribing doctor. Exception: UPMC has a standard prior authorization that can be used to ease this process!

Questions? Please do not hesitate to reach out! We are limited in what we can and can not do as we are unable to accept insurance directly, however we are gaining knowledge on this process regularly and can offer guidance and support!

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