Does Medicare Cover a Vasectomy?
In the United States every year, doctors perform over half a million vasectomies. Men choose to undergo this common surgical procedure as a permanent form of birth control. A vasectomy is done by surgically sealing off both of the vas deferens (tubes that transport sperm from the testicles), so the sperm can no longer reach the semen. Without sperm in the semen, an ovum can’t be fertilized, but men can still achieve orgasm.
Vasectomy procedures carry minimal risk, are non-invasive, and are done in outpatient settings while the patients are under local anesthesia. Not only is vasectomy almost 100 percent effective as a form of male contraception, but it’s less expensive than medication birth control for women.
Having a vasectomy may also be a better choice for a couple than a partner having a tubal ligation, which is the surgical sterilization procedure for females. A tubal ligation is done while the patient is under general anesthesia. These procedures are typically more expensive and can present more health complications than a vasectomy.
Does Medicare cover vasectomies?
Vasectomies are surgical procedures that a person can choose to have and aren’t considered medically necessary. Because having a vasectomy doesn’t serve a medical purpose other than contraception, it’s solely an elective procedure. Medicare insurance only covers medical services and supplies that it defines as being medically necessary, and for this reason, it doesn’t cover vasectomy, vasectomy reversal, or other sterilization procedures.
If you have coverage through Original Medicare Parts A (hospital insurance) and B (medical insurance), and you decide to get a vasectomy, Medicare won’t cover it and you’ll have to pay 100 percent of the cost yourself.
If you have coverage through a Medicare Advantage (Part C)plan, your private insurance provider may offer some coverage for your vasectomy. While all Part C plans are required by federal law to cover, at minimum, the same benefits provided by Original Medicare Parts A and B, they have the option to include additional coverage and extra benefits for beneficiaries.
Depending on the type of Medicare Advantage plan you’ve enrolled in, you may have additional coverage for some elective surgical procedures like a vasectomy. Before you make arrangements for your procedure, you should discuss the details of your coverage to ensure you are eligible for this benefit.
How much does a vasectomy cost without Medicare insurance coverage?
How much you pay for your vasectomy depends on where you live in the country, the physician who does your procedure, the medical facility where it’s done, what follow-up care is included, and other factors.
Today, most sources report that the national average cost for a vasectomy is between $1000 and $3000. These prices are still lower than a tubal ligation which can cost between $5000 and $8000 on average across the country today.