Will insurance cover labiaplasty due to a labia tear during child birth?

During my delivery of my son my left labia tore. The OB stitched it up but he did so while I was still swollen so when the swelling subsided the stitches were loose and didn't work. You can stick your pinky through the hole it left. It's very uncomfortable after sex. I'm wondering if my insurance would cover labiaplasty or if it would be considered strictly cosmetic?

Doctor Answers 10

Labiaplasty

Insurance companies will not likely cover your labiaplasty.  Be sure to choose a board certified plastic surgeon with a great reputation and that specializes in labiaplasty procedures.  Its important to choose someone who is qualified to perform this procedure.

Surgery coverage

First, call your insurance company and see what their guidelines are.  It is possible they may cover repair of the hole, but insurances are less and less covering labiaplasty for tissue reduction purposes.  Your doctor can help you with the codes.

Your childbirth injury repair should be covered by insurance, but not cosmetic labiaplasty

You have a medical problem caused by childbirth trauma. I see no reason why this wouldn't be covered by insurance. However, if you're looking to undergo a cosmetic labiaplasty at the same time, you can expect to pay out of pocket for that portion of the procedure.

Insurance questions are always tricky

I am so sorry that this happened to you. Hopefully you will be able to get your situation resolved quickly and your insurance company will be willing to help as well.

In general, every insurance company has their own method of determining coverage. For an issue such as you describe; a hole in your labia left from a repair of a labial tear during childbirth, many insurances may cover part or all of the procedure to fix your problem.

The gotcha here is "part or all". Your insurance company may decide (don't shoot the messenger):

  1. The issue is cosmetic and thus not covered.
  2. Closure of the hole is covered, but no other improvement would be covered.
  3. Full repair of the issue is covered.

There are many factors that go into which decision a particular insurance company makes for a particular patient. My suggestion would be to find a physician experienced with labial repair and have them give you an exam to determine the extent of repair needed/desired. Once this is accomplished, the physician's office can work with you and your insurance company to determine the full extent of you benefits.

As it is getting close to the last quarter of the year, I feel that I should also point out that many insurance benefits change annually. If you have insurance through an employer, even if you keep the same plan from one year to the next, the employer and insurance company may "renegotiate" the terms of each plan to help save money.

Good luck! I hope that you are able to find resolution soon.

Labial tear

This should be covered by insurance as it is due to an injury.  Either plastic surgery or Gyn can perform this procedure and obtain insurance coverage for you.

Susan Kolb, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 23 reviews

Labial tear

Thank you for your question.  If you suffered an injury that left you with some type of defect, insurance may cover the repair.  Consult with a board certified physician experience in labial surgery to discuss your options and determine insurance coverage.

Labial tear and insurance coverage

Thank you for your question. There may be a possibility of coverage for repair labial tear through your OBGYN. Full labiaplasty usually will not be covered by insurance. Please talk to your OBGYN

Torn labia after OB trauma

Thanks for the questions.  It is highly unlikely insurance will pay for a torn labia as it is considered a cosmetic procedure.  You might find a surgeon who will attempt to pass this through to the insurance company but I doubt you will find a surgeon who is skilled in labia surgery to do so.  You really should choose a surgeon who is experienced in revision or redo labiaplasties because these situations are similar to what you are dealing with.  Choose a surgeon who has the reputation, experience, expertise and who gets results.   See their website and specifically their botched labiaplasty or labia revision surgery portion of their site.  Best of luck in your care.  These are tough situations to correct. 


John R Miklos  MD

Atlanta ~ Beverly Hills ~ Dubai

Insurance may cover repair of Labial tear, but not Labiaplasty

Congratulations on your new baby boy, but sorry about the trauma to your labia at the time of your delivery. You should ask your Ob to repair the hole within your labia once your recovered from your delivery, 3 months should be enough time. However, if you want cosmetic improvement of the appearance of your labia, most likely a Labiaplasty, then this is not covered by insurance. You should look for an experienced cosmetic vaginal surgeon to perform this. Below is a link with advice in choosing the right surgeon. 

Best of luck,

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 23 reviews

Will insurance cover labiaplasty due to a labia tear during child birth?

Thank you for your question and I am sorry to hear of your labial injury.  In most cases a labiaplasty procedure is deemed cosmetic and will not be covered by insurance.  Repair of your injury alone may be covered, but anything other than repair of the hole would not be.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.