Will My Health Insurance Cover A Vasectomy?
A vasectomy is an operation that severs the vas deferens, two narrow channels that lead from the testicles to the urethra, the tube that carries urine out of the body. Typically considered a permanent method of birth control, there are ways to reverse this procedure. However, they are not always successful, so men are warned that vasectomies should be considered permanent.
Health insurance policies usually cover vasectomies, although few cover the reversal procedures. Vasectomies generally cost from $350 to $1,000 so having insurance coverage to pay for this procedure is very important.
What Happens During A Vasectomy?
The vasectomy is considered an out-patient procedure, so unless there are complications, most men simply go to the doctor’s office or an outpatient clinic and return home the same day. This is one of the reasons the vasectomy is a much cheaper and less complicated procedure than a tubal ligation for females, which often involves a hospital stay or a longer recovery period.
Prior to the operation, the doctor will discuss your reasons for having a vasectomy and explain the results. Doctors want to be sure that men understand that once they have a vasectomy, there is no guarantee they will ever be able to father a child. Doctors will be more concerned with this part of the procedure if the patient is very young, is unmarried or is not in a committed relationship, because a man who has not had any children may one day decide he wants to start a family.
During a vasectomy, the doctor administers a local anesthetic to the testicular area and may give the patient some type of calming medication to reduce stress and pain. The doctor then makes a very small incision in the side of the scrotum, the sack that holds the testicles, to access the vas deferens, the tubes that carry sperm to be mixed with the semen. There are two of these tubes, one on each side, and they must be cut and then sutured apart to keep them from growing back together. The incision is then closed and packing applied to the area. Most men take pain pills for some days after the operation but usually there are not any serious complications. Infection is the biggest worry; men may be asked to take antibiotics as a preventative but in most cases the incision heals without difficulty.
Patients are also warned to use some other form of birth control for some period of time after the vasectomy. This is because the sperm in the tubes may not be completely flushed from the system. Men are usually asked to come back in a month and give a semen sample so that the doctor can test to be sure that the sperm are not still present.
A vasectomy does not interfere with sexual performance. There is really no way to notice the difference in semen content or amount, so a sperm test is necessary to ensure that the man cannot impregnate his partner.
What Part of the Vasectomy Is Usually Paid For By Health Insurance?
How much your health insurance pays toward the vasectomy depends on the type of coverage you have. Most health insurance policies cover vasectomies as long as a doctor has recommended the procedure as a safe method of birth control.
If your insurance includes a deductible and co-payment, these will have to be met prior to the insurance company paying anything on the operation. For example, if your insurance requires a $500 deductible and a 20 percent co-payment, a $1000 vasectomy will cost you $600 in out-of-pocket expenses: $500 for the deductible and $100 for the 20 percent co-payment of the remaining balance. However, if you have already met your deductible, you will pay less. For this reason, some men elect to have this surgery later in the year after they have already met the deductible cost. Some HMO plans pay most of the cost without a deductible, and some health insurance policies have higher deductibles. In order to determine how much you will have to pay, review your insurance information and determine how much of your deductible you have already met.
A vasectomy is a very minor procedure when compared with other types of surgery. However, that does not mean that you should not take this procedure seriously from both a medical and a financial standpoint. Review your information to determine exactly how much you will owe; if you need help, your doctor’s office is usually happy to help you determine your cost.