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Does Health Insurance Cover Vasectomy

Is There A Way To Have A Vasectomy Done For Free

Men’s Health Moment: Vasectomy Reversal: Overview

There may be programs in your area that provide low-cost or no-cost vasectomies. “A good starting point is your local health department,” according to Dr. McHugh. “If they don’t offer it, they may be able to recommend a clinic in a nearby community.”

“Vasectomy is a much more straightforward, minor procedure when compared to a tubal ligation. Medical insurance, including most private plans as well as state-run programs like Medicare and Medicaid, will cover a vasectomy because it is more cost-effective than the cost of most birth controls and other sterilization procedures, and is clearly less expensive than the prenatal, delivery and postnatal cost associated with having a baby,” according to the good doctors at Chesapeake Urology in Maryland.

“Depending upon the state you live in, and the regulations, laws, and programs available, there may be programs that will provide low-cost or free vasectomy procedures. Planned Parenthood is a program that has assistance for sterilization and birth control, and it would be a good place to start your inquiry,” they add.

How Effective Is A Vasectomy

A vasectomy, also known as male sterilization, is considered a permanent birth control method. In the United States, an estimated 527,476 vasectomies were performed in 2015. In some regions, such as the U.K, the number of men undergoing a vasectomy has dropped significantly in recent years.

A vasectomy is a surgical procedure. Yet the cost is about five times less than the cost of tubal ligation .

Before you seek a vasectomy, it may help to ask your healthcare provider about any laws or rules that apply in your state. In some areas, there may be waiting periods, age restrictions, required counseling, or spousal consent.

Does The Va Pay For Vasectomy Reversals

Through VA health care, enrolled Veterans have access to many different types of fertility treatments, procedures and services including infertility counseling, laboratory blood testing, genetic counseling, sperm testing, ultrasounds, surgery, reversal of a vasectomy or tubal ligation, medication and other treatments.

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Will Aetna Cover Vasectomy

Aetna does cover vasectomy in most cases however, how much coverage you have depends on several factors.

1. What is your deductible with Aetna?Some health insurance plans have high annual deductibles. This means if you have such a plan you must make monthly payments for your health care premiums and also pay directly out of pocket for any health care expenses until pay your deductible for that year.

After you meet your annual deductible then Aetna will cover the cost of your office visits and procedures for the rest of the year. When the year rolls overthe annual deductible game starts all over again!

2.Where are you in your deductible contribution with Aetna for the year?If you have not paid anything towards your Aetna deductible then you may have to pay for your entire vasectomy. Dont worry because at His Choice we have your back because we only charge $640 total for an entire single visit vasectomy procedure.

Even men with high annual deductibles will find $640 affordable. We do this because many men will have high deductible plans and will not be able to afford vasectomy because of their annual deductible. We have heard horror stories of vasectomies costing as much as $3,000! Many men, even those with health insurance coverage, may not be able to afford vasectomy because of the cost most vasectomy doctors charge.

3. Is the procedure performed in an office or hospital?

How Do I Prepare

AETNA Coverage for No

Ask your doctor about precautions. In general, dont eat breakfast on the day of the procedure, and dont take aspirin or ibuprofen for two weeks before your vasectomy and for a week afterward to decrease the risk of bleeding. On the day of the operation, shower beforehand and wear loose-fitting pants and underwear.

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Does Insurance Pay For Vasectomy Reversal Costs In 2022

The goal of this article, by microsurgeon and author Dr. Sheldon Marks, is to explain how and why insurance rarely pays for a vas reversal.

Bottom line, for most men a vasectomy reversal is usually not covered by most insurance plans. Insurance companies think it is an elective and so not a medically necessary procedure. They do not want to pay for correcting a past decision that men now regret. Plus, I have been told by an insurance insider that a successful vasectomy reversal will increase insurance company costs as they now have to pay for the delivery and costs for more children with no additional income to cover these expenses.

How to find out if insurance will pay for the vasectomy reversal? Because there are many thousands of insurance plans and so many variations within each plan, each patient will have to call the insurance company and find out if the specific plan that they have will cover an outpatient microsurgical vasovasostomy . It is best not to say the words vasectomy reversal.

Plus, because we know that a well performed microsurgical reverse vasectomy is not cheap, we offer payment options for most couples.

If there are any questions about vasectomy reversals or to set up a no-cost phone, Skype, Zoom, in office or Face Time consultation with one of the 2 microsurgeons, please call our full-time, vas reversal only center at .

This page was reviewed, edited and updated August 13, 2022 by Sheldon H. F. Marks, MD.

What Are The Benefits Of A Vasectomy

Vasectomies are a reliable and cost-effective form of birth control that is almost always reversible.

Key Takeaways

  • A vasectomy is a type of surgical sterilization for men that prevents pregnancy that is covered by many insurance plans.
  • Since the procedure is not considered an essential health benefit under the Affordable Care Act, not all health insurance plans cover a vasectomy.
  • Without insurance, a vasectomy would typically cost about $1,000 out-of-pocket.

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How Do You Determine If A Vasectomy Is Covered By Health Insurance

Although most health insurance companies will cover a vasectomy not all policies pay for the procedure the same way. For this reason, it is the insureds responsibility to contact their company to discuss benefits. Under most situations, most of the charges associated with a vasectomy will be covered by your insurance company. However, you may be responsible for:

A copay is a flat fee due at each doctors visit. If your insurance makes a distinction between primary care and specialists co-pays, you will likely be responsible for the experts co-pay.

The deductible is a fixed amount that is the insureds responsibility before the policy begins to pay benefits.

Lastly, coinsurance is a percentage of doctors costs that a patient is responsible for. For example, your policy may require you to pay 20-percent of all approved charges.

What Are The Types Of Health Insurance

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There are two types of private health insurance. Theres hospital cover and extras cover . Extras is for dental and physio for example. Most insurance providers will offer a bundle where youre covered for both.

Were going to be focusing on private Hospital cover, as this is the coverage relevant to a vasectomy when done in one of our specialist Day Hospitals.

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Do I Qualify For A Vasectomy

Legally speaking, anyone over the age of 18 is eligible for the procedure, and there is no medical referral required in order to consult with a vasectomist. Vasectomy is a method of contraception for people who have decided that they dont ever want children, or who have children and are certain they dont want more.

Health Insurance And Vasectomies

The majority of health insurance companies will cover at least some of the cost of a vasectomy, especially if the procedure is performed in an outpatient setting. However, before you schedule an appointment, its important that you check your plan to make sure that it does offer coverage for the procedure. Typically, health insurance companies cover all or the majority of the expense once policy holder has met his deductible.

If you have health insurance, whether through your employer or through the , contact your carrier to find out if your plan does offer coverage for the procedure. Ask for the details of your policy for example, you may have to have the procedure done by an in-network doctor if you do and you have the procedure done by an out-of-network doctor, you may end up having to cover the entire cost of the procedure out of your own pocket. Additionally, if the procedure is covered by your insurance, make sure you find out about any out-of-pocket expenses that you will be responsible for for example, your deductible and any copays.

Ask for the details of your health insurance plan so that you have a hard copy you can refer to. Also, when you schedule an appointment, be sure that you find out if the facility accepts your insurance. If you qualify for Medicaid or other state medical programs in your local area, a vasectomy may be covered, as well.

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What Are My Best Steps For Getting Coverage

Youll need to find a Medicare Advantage plan that offers vasectomy coverage. There are a few ways you can do this:

  • Talk with your doctor. A great first step is to talk with your doctor or a billing representative at your doctors office. They might be able to point you to a list of insurance companies they accept, then you can contact the companies to determine which ones cover a vasectomy.
  • Contact local Medicare Advantage companies. You can also contact Medicare Advantage plan providers in your area directly. Use the Medicare website to find the plans offered in your ZIP code. You can narrow your search to plans that fit your budget and include your doctor in the network. From there, you can call those plans and ask a representative if they cover vasectomies.
  • Find additional help. Another option is contacting your local State Health Insurance Assistance Program center. A SHIP counselor can give you information about the Medicare plans offered in your area, including details about what they cover. They can also answer any other questions you might have about Medicare. SHIP counselors are trained to provide unbiased and locally based advice.

The cost of a vasectomy is affected by many factors. While Planned Parenthood reports that vasectomies cost between $0 and $1,000, your costs will depend on your individual circumstances.

These may include:

When youre using a Medicare Advantage plan, your price could be affected by:

Costs Vs Other Forms Of Birth Control

Vasectomy Cost Without Insurance / Vasectomy Reversal Frisco TX ...

It’s important to weigh the costs of a vasectomy against the costs of not having one. If you are certain that you wish to prevent pregnancy, then it’s necessary to look at how effective it is.

The cost of having a child is substantial. It’s not just an unplanned pregnancy that must be considered when comparing the cost of a vasectomy with other birth control methods.

Other forms of birth control can be pricey if not covered by health insurance. A birth control pill is inexpensive, for example, but all those months across a lifetime will add up until menopause. The cost could well exceed that of a vasectomy.

Some methods may also present health risks over time, as is the case with blood clots linked to using some birth control pills. Common side effects include weight gain or mood swings, and in those who have a genetic predisposition to breast cancer, the pill can mildly increase the risk.

An intrauterine device can be very effective, but there is always the looming risk of infection. There is also a risk of a perforation caused by the IUD pushing through the wall of the uterus.

Likewise, a lifetime supply of condoms may or may not cost more than a vasectomy. It depends on your taste and how often you might need them. A vasectomy is much more convenient, though it’s critical to remember that it will not lower the risk of sexually transmitted diseases as condoms do.

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How Does The Cost Of A Vasectomy Compare To That Of Tubal Ligation

The sterilization procedure for men is significantly less expensive than female sterilization, a procedure known as tubal ligation. Tubal ligation can be four to six times more costly and is a longer, more invasive, and more complex procedure that requires general anesthesia and must be performed in a hospital or surgery center.

Does Insurance Cover Vasectomy

Does Insurance cover Vasectomy? Vasectomies are a very common occurrence in the world today. The number of vasectomies has increased steadily over the past decade.

The American Urological Association estimates that about 500,000 men about 1 percent of all U.S. males get a vasectomy every year, making it one of the most common male-sterilization procedures in the country and the world.

According to statistics from the Centers for Disease Control and Prevention , doctors perform as many as 40 percent more vasectomies now than they did in 1990, when only 257,145 vasectomies were recorded in the United States. Doctors performed 615,886 vasectomies in 2009 for example, almost doubling 1990 numbers. The CDC attributes this growth partly to an increase in health coverage under Obamacare and similar state programs that cover family planning services such as sterilization procedures like a vasectomy at no cost to patients.


  • 11 Step 6 Does the plan require you to be treated by an In-network dentists?
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    Why Choose New York Urology Specialists For Your Vasectomy

    • All vasectomies are performed by a board-certified urologist experienced in performing vasectomies, not an assistant. Our vasectomy dr is one of the most experienced specialists who perform no-scalpel, no-needle vasectomy in NYC.
    • We are one of the few practices in the region to offer no-needle, no-scalpel vasectomy.
    • We offer vasectomy under local anesthesiawhich avoids the risks, costs, and recovery from general anesthesia. Most men are able to return to office work and other normal activities the next day.
    • Extensive Experience: Hundreds of successful no-scalpel vasectomies performed under local anesthesia at the Vasectomy Center at New York Urology Specialists.
    • We are one of the few practices in the region to offer a full range of options for the treatment of sexual and erection problems in men.
    • We are conveniently located within 30-60 minute commute to men who are seeking vasectomy in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.

    What Is Hospital Insurance

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    Depending on your individual policy, hospital insurance is designed to help cover some, or all, of the cost of in-hospital treatment, either as a private patient in a public hospital, or in a private hospital or licensed day hospital practice.

    Generally, any medical service listed under the Medicare Benefits Schedule such as vasectomy can be claimable on some form of private hospital insurance, depending on your policy.

    Almost all clients who have private health insurance Hospital cover who are paid up on their membership will be covered for vasectomy in all our hospitals. Our hospital will run a final check for you a few days before your procedure date to confirm this. You can also contact your insurer and have them check in advance by quoting item number 37623.

    If youre covered and you book at one of our day hospitals, you may have to pay an excess and / or a gap fee depending on your policy.

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    Find Out About Your Dental Coverage

    You need to know more about your dental coverage. Call your insurance company and find out what is included in the plan. Here are some of the questions that you need to ask:

    • What is the plan maximum benefit?
    • What is the annual deductible?
    • What is the coinsurance rate?
    • What is the waiting period?
    • What are exclusions and limitations?

    Will Medicare Or Medicaid Cover A Vasectomy

    In many states traditional Medicaid covers vasectomies. Hawaii and the District of Columbia do not offer this benefit in their ACA Medicaid expansion programs.

    Medicare parts A and B, Part D and Medigap wont cover vasectomies or other elective procedures, but Medicare Advantage plans may include vasectomy coverage. Policyholders should check with their plan provider to see if vasectomies are included in their coverage.

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    Will Health Insurance Cover Vasectomy Reversal

    May 24, 2016 By Rob Schwab

    The ACA was designed to ensure benefits for underserved groups, including women. Thanks to mandatory essential care stipulations, many healthcare services for women are now covered by insurance, including well woman visits and FDA approved contraception.

    In addition, permanent forms of birth control, such as tubal ligation, are now included under essential coverage requirements. Although women now enjoy coverage for permanent forms of birth control, Obamacare does not stipulate coverage for vasectomy as essential. This doesnt necessarily mean that insurance wont cover the procedure, but insurance providers are not required by law to include this coverage.

    The next question many people have is whether or not Obamacare covers reversal of permanent contraception. In the case of tubal ligation, the answer is no. The law does not mandate coverage for reversal of tubal ligation, although neither does it prohibit this coverage.

    What about vasectomy, though? Is vasectomy reversal covered under Obamacare? Will it be covered by health insurance policies?

    Is Vasectomy Reversal Covered Under Obamacare?Unfortunately, the answer is no. Like tubal ligation and other permanent forms of contraception, reversal procedures are not deemed essential and therefore coverage is not mandatory. Many groups are advocating for further coverage for men where reproductive health and contraception are concerned, but thus far no changes have been made.


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