Navigating insurance coverage for gender-affirming care can feel overwhelming, but the good news is that more and more insurance companies are recognizing the medical necessity of permanent hair removal , especially hair removal that is a prerequisite for gender-affirming surgery.
If you’re insured and considering electrolysis, it’s a good idea to contact your insurance company directly to see if your plan will cover or reimburse the cost. Below, we’ll walk through some key steps and information to help you advocate for yourself and get the coverage you need.
Whether or not your electrolysis provider can bill insurance directly depends on their contracts (if any) with insurance companies. Some providers are only contracted with specific plans, while others may offer reimbursement options if they can’t bill your insurance directly. Ask your electrolysis provider whether they are in-network with your insurance.
If your provider can’t bill your insurance, you’ll still want to gather the following information, as you may be able to submit your receipts to your insurance company for reimbursement. Just note that if you haven’t met your deductible, you’ll likely need to pay out-of-pocket at first, but this amount will count toward your annual deductible. (If insurance terms are unfamiliar or confusing, check this guide and glossary for trans health coverage.)
Reimbursement through insurance looks like this: you'll pay the full rate for your electrolysis sessions upfront. After payment, your provider will send you an invoice, which you can submit to your insurance company for reimbursement. Keep in mind that reimbursement can take several weeks or even months, so it’s best to start this process early—ideally before your first appointment.
Be sure to ask your provider if they can help you with any necessary paperwork, like invoices and prior authorizations, which can be required for getting reimbursed.
A prior authorization (PA) is a letter that your medical provider sends to your insurance company to explain why a procedure is medically necessary. For many people, getting a PA approved is the key to having electrolysis covered by insurance.
You’ll need a medical professional—such as your primary care provider, endocrinologist, or surgeon—to send a PA request to your insurance company. It’s also helpful to include specific procedure codes in the PA to make sure the request is processed smoothly (more on those below.)
Even if your insurance policy states that gender-affirming hair removal is covered, claims can still be denied without a PA on file. If a claim is denied despite an approved PA, the appeals process is generally quicker and more efficient, so definitely seek a PA if you can.
Here’s what your provider will likely need to include in the PA:
It’s also helpful to request a PA for more hours of electrolysis than you think you’ll need (for example, 300 hours). This ensures you’ll have enough approved time for the entire duration of your treatment, without needing to reapply for more coverage later.
Additionally, some insurance companies may request an electrolysis treatment plan, detailing the estimated number of sessions and overall cost. Your electrologist can usually provide this treatment plan, and it's often best if your primary care provider or surgeon submits it along with the PA request. Having this plan ready upfront can streamline the process and help prevent delays in obtaining coverage.
Be sure that your electrologist includes their NPI number and CPT code on any receipts, as these details can make it easier for you to submit for reimbursement if needed.
If your PA is rejected, it’s important not to give up. Contact your insurance company’s member services department (you can usually find the number on the back of your insurance card) and explain that you’re seeking medically necessary hair removal as part of gender-affirming care.
We’ve found that the highest success rates typically come when permanent hair removal is sought as preparation for a gender-affirming surgical procedure, such as bottom surgery. If this is you, you may need to use language that feels outdated or inaccurate for many of us when talking to an insurance rep. Unfortunately, this terminology is often a necessary step in navigating an insurance system that wasn’t designed with our needs and experiences in mind. You’ll want to state that you are medically diagnosed with "Gender Identity Disorder, unspecified" (F64.9 in the ICD-10) and that: "I need hair removal as part of preparation for sex-reassignment surgery."
We'd like to note: we've seen less success from folks who are seeking coverage for permanent hair removal on the face or neck. We understand how frustrating and unfair this is, especially since facial and neck hair removal isn’t cosmetic—for so many of us, it’s a vital part of our transition. Know that this type of hair removal is just as medically necessary, and we hope that insurance policies will evolve to better recognize and support our full range of needs.
Sometimes, insurance representatives may not fully understand policies related to gender-affirming procedures. If you’re told that hair removal isn’t covered, keep asking questions. Some insurance companies have supervisors or specialized gender-care representatives who can help with more complex claims. Keep a log of all your conversations—advocating for yourself is key.
Getting insurance coverage for electrolysis can be a lengthy process, but it’s worth it to ensure you receive the care you need. By asking the right questions and staying persistent, you'll increase your chances of getting coverage or reimbursement for your treatment.
If you're unable to afford electrolysis, Point of Pride offers an Electrolysis Support Fund to help trans folks access these hair removal services.