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Imagine finally committing to electrolysis for permanent hair removal—only to realize your insurance might not cover it. It’s frustrating, confusing, and surprisingly common. Electrolysis is often dismissed as “cosmetic,” even when it plays a crucial role in your health or gender-affirming journey.
But here’s the thing: sometimes, insurance does cover electrolysis. You just need to know when, why, and how to advocate for it.
In this guide, we’re going beyond generic advice. You’ll learn:
- When insurance may cover electrolysis (with real examples)
- How to get a letter of medical necessity
- What transgender individuals and people with PCOS should know
- Tips to increase your approval odds
Let’s break it all down.
What Is Electrolysis—and Why It Matters
Electrolysis is the only FDA-approved method for permanent hair removal. It involves inserting a thin probe into the hair follicle and applying electric current to destroy the root. It works on all hair types, unlike laser hair removal.
People pursue electrolysis for many reasons:
- Gender affirmation
- Hirsutism caused by PCOS or hormonal conditions
- Hair removal for surgical preparation
- Chronic ingrown hairs or infections
But here’s the catch: insurance companies often lump it into the “cosmetic procedure” category, which they rarely cover. That said, there are major exceptions.
When Does Insurance Cover Electrolysis?
1. Gender-Affirming Surgery Preparation
For transgender individuals undergoing gender-confirming surgery (like vaginoplasty or phalloplasty), electrolysis is often required to prevent hair growth on surgical sites. In these cases, insurers are more likely to cover it under gender-affirming care.
✅ Example:
Premera Blue Cross and Aetna cover pre-surgical electrolysis when it’s part of a medically necessary gender transition procedure. The World Professional Association for Transgender Health (WPATH) also supports it as a necessary medical step.
“I was able to get my insurance to cover electrolysis for bottom surgery prep. It took a letter from my surgeon and a few appeals, but it worked!”
— Lena, transgender woman, Portland, OR
2. Polycystic Ovary Syndrome (PCOS)
PCOS can cause hirsutism—excessive facial or body hair due to hormonal imbalance. This isn’t just a cosmetic issue; it can impact self-esteem and mental health.
If your doctor diagnoses PCOS and confirms that the hair growth causes psychological distress or medical complications (like infections), you may be eligible for coverage.
What Helps:
- A documented diagnosis (ICD code E28.2 for PCOS)
- A referral from an endocrinologist or dermatologist
- Evidence that you’ve tried other treatments first
“My insurance wouldn’t cover laser hair removal, but after my endocrinologist wrote a letter explaining the mental health impact of hirsutism, they approved a few sessions of electrolysis.”
— Carmen, PCOS patient, Austin, TX
3. Surgical Site Preparation (Non-Transgender)
Even for non-transgender individuals, electrolysis may be covered if it’s required before a surgery—like a skin graft or reconstructive procedure—where hair growth would interfere with healing.
Ask your surgeon to provide:
- A clear explanation of the medical necessity
- A CPT code (like 17380 or 17383)
- Supporting documentation or images
How to Get Electrolysis Covered: A Step-by-Step Plan
✅ Step 1: Get a Diagnosis or Referral
Start by visiting a licensed professional—like a dermatologist, endocrinologist, or surgeon—who can verify that hair removal is medically necessary. Insurance companies want proof that this isn’t elective.
✅ Step 2: Request a Letter of Medical Necessity (LMN)
A strong LMN is your best weapon. It should include:
- Your diagnosis
- Why electrolysis is necessary
- Why alternatives (like shaving or laser) are insufficient
- Estimated treatment area and duration
📌 Here’s a template for an LMN that works well for transgender surgery prep and PCOS-related hirsutism.
✅ Step 3: Get Prior Authorization
Submit the LMN and supporting documents to your insurer before starting treatment. Ask for the following:
- Confirmation of coverage
- Approved number of sessions
- In-network providers (if available)
✅ Step 4: Track All Correspondence
Keep a paper trail:
- Letters and emails
- Phone call notes (including the rep’s name and ID)
- Receipts and billing codes
If you’re denied, don’t panic. Most approvals happen after appeals—especially if you escalate to an external review board.
Insurance Codes for Electrolysis
| Procedure | CPT Code | Description |
|---|---|---|
| Electrolysis hair removal | 17380 | Destruction of hair follicles, face/neck area |
| Hair removal by laser | 17383 | Laser surgery for hair removal (usually not covered) |
Knowing the codes helps your provider bill correctly and improves your chances of approval.
FSA & HSA Options for Out-of-Pocket Costs
Even if your insurance doesn’t cover electrolysis, you might be able to use FSA (Flexible Spending Accounts) or HSA (Health Savings Accounts) to pay for it tax-free.
To qualify:
- You must have a medical reason for treatment (e.g., PCOS or pre-surgical prep)
- A doctor should write a note explaining the necessity
For more, check IRS Publication 502 on medical expense deductions.
Key Differences: Insurance Coverage by Situation
| Condition | Insurance Coverage | What Helps Approval |
|---|---|---|
| Gender-affirming surgery | Often covered | WPATH standards, surgeon referral |
| PCOS or hirsutism | Sometimes covered | Endocrinologist letter, mental health documentation |
| Cosmetic hair removal | Rarely covered | Not typically eligible |
| Pre-op for non-trans surgeries | Occasionally covered | Clear surgical recommendation |
Common Mistakes to Avoid
- Assuming it’s never covered: Many give up too early. Some states now require insurers to include transgender care.
- Starting treatment before approval: That’s a fast track to out-of-pocket expenses.
- Using the wrong terminology: Avoid saying “cosmetic” or “beauty”; emphasize “medical necessity.”
Final Thoughts: Is It Worth the Fight?
Electrolysis is more than a beauty treatment. For many, it’s life-changing—alleviating gender dysphoria, treating hormone-related hair growth, or prepping for surgery. And yes, in the right circumstances, insurance can cover it.
But you’ll need:
- Strong documentation
- Persistence with prior authorization
- Willingness to appeal if necessary
Ready to Take the Next Step?
If you’re considering electrolysis and want to see if insurance will help cover it:
- Talk to your doctor about writing a letter of medical necessity.
- Contact your insurance company with the proper CPT codes and documentation.
- Don’t be afraid to appeal. Approval often comes after the second or third try.
📩 Have a story to share about getting insurance to cover electrolysis? Drop it in the comments—we’d love to feature your experience in a future post!
🔍 Looking for related content? Check out our deep dives on:
- [Does insurance cover laser hair removal?]
- [Can you get health insurance with PCOS?]
- [How to appeal an insurance denial step by step]
