This article was updated on March 17, 2021.
Original Medicare does not generally cover vasectomies or other elective surgeries unless deemed medically necessary by your primary physician. Medicare Advantage plans may cover the procedure. If a person has a Medicare Advantage plan, they can check to see if the plan offers coverage. A person may have related out-of-pocket costs such as deductibles, copays, and coinsurance.
What is a vasectomy?
A vasectomy stops sperm from entering semen and thereby prevents pregnancy and is a form of permanent sterilization. More than half a million men undergo the procedure every year, according to the Urology Care Foundation.
The surgical procedure involves cutting the vas deferens, which are the two tubes that take sperm to the urethra, via the testicles.
The two types of vasectomy procedures include ‘conventional’ and ‘no-scalpel.
During a conventional vasectomy, the urologist makes small cuts in the scrotum skin to get to one of the vas deferens. The tube is then cut, with the ends either sutured or seared. The procedure is repeated on the other tube.
The no-scalpel vasectomy involves the urologist making a small hole in the scrotum skin, and stretching it to enable the vas deferens to be lifted and cut. The ends are then seared or sutured, and replaced in the testicle area. Although a surgeon can, in some cases, reverse a vasectomy, they cannot guarantee success.
Medicare Advantage coverage
Medicare does not consider a vasectomy a medically necessary procedure, so original Medicare will not cover the cost. Medicare Advantage plans may offer coverage. A person can check with their plan provider to find out if coverage extends to vasectomies.
The average cost of a vasectomy ranges from $0– $1,000, depending on various factors:
- where the vasectomy is done
- the kind of surgery
- whether or not a person has health insurance
- if a person has Medicaid or any other government program
Talk to your doctor about your options before moving forward with any type of surgery or procedure.
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