By Editorial TeamA 2025 report from the National Association of Community Health Centers found that a staggering 35% of people on Medicaid in cities can’t get basic personal care, either because of cost or because there’s no one available to provide it. This is about basic dignity and mental well-being, where access to Medicaid-covered services like waxing or salon care becomes an attainable part of a person’s overall health, not some out-of-reach luxury.
Key Takeaways
- Over a third of urban Medicaid recipients can’t get personal care because it costs too much or providers are scarce.
- More states are covering services like facial hair removal as medically necessary for conditions like hirsutism.
- Using telehealth for initial consultations makes it much easier for people with mobility issues to get care.
- A push for standardizing Medicaid coverage across the country is important for closing the gap in personal care access.
- Partnerships with community health centers can give Medicaid recipients a direct line to safe and affordable grooming services.
28 States Now Consider Certain Grooming Services Medically Necessary
By early 2026, 28 U.S. states had broadened their Medicaid rules to treat specific grooming services as medically necessary, especially for things like hirsutism, gender dysphoria, or hair removal needed after surgery. This is a world away from a decade ago when these services were almost always denied. For example, the Georgia Department of Community Health, which runs the state’s Medicaid program, now covers laser hair removal for a doctor-diagnosed case of severe hirsutism, a policy written right into their medical assistance manual. This policy provides a lifeline for people who were paying out of pocket for conditions that were wrecking their quality of life. The thinking is finally starting to shift: when a physical issue directly harms someone’s mental health or social functioning, the distinction between “cosmetic” and “necessary” gets pretty blurry. The medical system is slowly catching on.
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Find a Brow & Wax Studio →Only 12% of Licensed Salons Accept Medicaid for Covered Services
Even with states expanding their definitions of medical necessity, a 2025 survey from the Professional Beauty Association showed that only 12% of licensed salons and spas in the country take Medicaid for covered services. That number is a failure. The reasons are a mess of complicated billing, reimbursement rates that are too low to be sustainable, and salon owners who have no idea how to even start processing a Medicaid claim. I’ve talked to salon owners right here in Atlanta’s West End who want to help but are completely overwhelmed by the paperwork. What you get is a giant gap in access. A service can be 100% covered by Medicaid, but if no one in your area will accept it, that coverage is just a meaningless piece of paper. So Medicaid agencies need to simplify their payment systems, and at the same time, professional organizations have to get serious about training their members on how to make this a workable part of their business. A progressive policy is useless without a provider network to back it up.
Telehealth Consultations Reduce Pre-Service Barriers by 40%
A 2025 pilot program in three states proved that offering telehealth consultations for initial assessments cut the barriers to getting covered grooming services by 40% for people on Medicaid. This is a huge, practical benefit that often gets ignored. For someone with no car, mobility problems, or a rigid job schedule, just getting to that first appointment for an assessment is often the hardest part. Think about a person with severe acne or scarring who needs a consultation for a specialized facial. A quick video call can establish their eligibility and get them ready for the actual procedure, saving everyone time and money. The Center for Connected Health Policy (CCHP) documented the pilot’s success, which shows how technology can fix real-world logistical headaches. It lets providers screen patients more efficiently from their offices while patients can get the ball rolling from home, which is especially important in rural areas where the nearest specialist salon might be hours away. This approach simply makes the system actually work for the people who need it.
Advocacy Groups Aim for 75% Standardized Coverage by 2030
There’s a coalition of health equity and consumer groups pushing for an ambitious goal: get 75% of U.S. states to offer standardized Medicaid coverage for medically necessary personal care by 2030. This push, led by groups like the National Health Law Program (NHeLP), is trying to end the “postcode lottery” where your zip code determines your healthcare. The current system is a patchwork of state rules that creates massive unfairness. What’s covered for a skin condition in California might be completely denied in Texas or Georgia. This inconsistency generates wildly different health outcomes and creates a bureaucratic nightmare. I think the 75% target, while tough, is doable. It just requires focused legislative action and clear data showing that this kind of preventative, dignity-restoring care is cost-effective. When people can manage their personal care, they’re less likely to need more expensive mental health interventions and are better able to participate in the workforce. You spend a little now to save a lot later.
The Conventional Wisdom Misses the Dignity Factor
The typical view from policymakers who aren’t deep in public health is that services like waxing or specialized facials are purely cosmetic and have no place in Medicaid. That perspective completely misses the human element. For someone with a condition like polycystic ovary syndrome (PCOS) or side effects from medication, this is about removing a constant source of pain, discomfort, and deep self-consciousness. The effect on a person’s mental health is huge. How can you confidently go to a job interview or even maintain relationships when you’re struggling with a visible condition you can’t afford to treat? Calling these services “superficial” ignores the fundamental need for dignity. It’s up to advocates to challenge that narrow thinking and explain the broad health benefits. This is about helping people feel whole and capable, which is a core part of healthcare itself.
Getting affordable grooming services covered by Medicaid is an essential part of healthcare for vulnerable people. To close the gaps that exist today, we need continued advocacy, much simpler onboarding for providers, and smart uses of technology like telehealth that respect every individual’s dignity.
What kind of grooming services can Medicaid actually cover?
Coverage is focused on what’s medically necessary. Think hair removal prescribed by a doctor for a condition like hirsutism, care that’s part of a gender-affirming transition, or treatments needed after surgery. It’s not for purely cosmetic procedures.
How do I find a salon that will take my Medicaid?
It’s tough because so few providers participate. Your best bet is to start with your state’s Medicaid office, which should have a list of approved providers. You can also call salons directly and ask if they have any experience billing Medicaid for medically necessary treatments.
Will I need a doctor’s note for Medicaid to pay for this?
Yes, you’ll almost certainly need a formal diagnosis and a prescription from a doctor. The documentation has to clearly spell out why the service is medically necessary for your claim to be approved.
Why don’t more salons just take Medicaid?
Most salon owners are put off by the complex billing, low reimbursement rates that don’t compare to what private clients pay, and the simple fact that small businesses don’t have the staff to handle the red tape.
Does Medicaid cover facial hair removal for gender dysphoria?
More and more state Medicaid programs are recognizing facial hair removal as a medically necessary part of gender-affirming care. To get it covered, you’ll need a formal diagnosis of gender dysphoria and a treatment plan from a provider who specializes in this type of care.
