Written by Christa Ehrler
Christa Ehrler is a wordsmith, copywriter, and traveler with over seven years of digital publishing experience. She is a.
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Updated September 15, 2022Expert Reviewed
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A vasectomy is a reversible form of birth control for men. According to the Association of Reproductive Health Professionals, vasectomies are covered by 70% of insurance companies. Since vasectomies are not essential federal health benefits under the Affordable Care Act (ACA), private insurance plans may not always cover them. If your insurer covers this procedure, you may have to use an in-network doctor and/or pay a copay, coinsurance or deductible costs. Each insurance plan is different, so you must check with your insurer. Vasectomies are not covered by Original Medicare, but they may be covered by the Medicare Advantage plan.
The typical cost for a vasectomy without insurance can cost anywhere from $250 to $1,000. Aftercare, including semen analysis, can increase the cost of your vasectomy. How much you pay out-of-pocket really depends on whether you have insurance and what your policy covers. If you decide to reverse your vasectomy, which is typically not supported by insurers, it could cost around $6,000 to $15,000.
Find the Best Health Insurance Coverage PlanMany factors can affect the cost of your vasectomy; for example, whether you have a no-cut procedure or an incision. Many vasectomies are done in doctor’s offices with local anesthesia. You may have to pay more if you have the procedure done at an ambulatory surgical center.
Total costs for a vasectomy often include:
Vasectomies are covered by 70% of insurance companies.
The cost of a vasectomy is typically less than $1,000, but several factors can affect cost including:
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 won’t cover vasectomies or other elective procedures, but Medicare Advantage (Part C) plans may include vasectomy coverage. Policyholders should check with their plan provider to see if vasectomies are included in their coverage.
Since vasectomies are not a preventive service under the Affordable Care Act, federal law does not require health plans to cover vasectomies. Each insurer’s coverage varies from policy to policy. If you don’t live in one of the five states that mandate which vasectomies should be at no cost to patients (Illinois, Maryland, Vermont, Oregon, and Washington) and you have a private insurance policy instead of Medicaid, you’ll need to look at your specific insurance policy terms.
The cost of a vasectomy is typically less than $1,000, but several factors can affect cost.
If your current policy doesn’t cover vasectomy, you may be able to buy supplementary coverage that does. Or, during the next open enrollment period for insurance, you could look for an insurer that includes vasectomy as one of its covered services.
For most patients, acetaminophen or ibuprofen — along with ice packs — is sufficient enough to address any pain or soreness for the next two or three days. If necessary, your doctor can prescribe pain medication, which will likely be covered by your insurance company.
Find the Best Health Insurance Coverage PlanYou'll need to take it easy and relax for 24 hours after your vasectomy. After two or three days you may be able to do light activity, and you should wait a week before doing heavy work, sports or lifting.
Almost all vasectomies are reversible. However, the longer it has been since your procedure, the less likely the reversal will work.
Vasectomies are a reliable and cost-effective form of birth control that is almost always reversible.
Key Takeaways
Most insurance plans cover a portion or all of your vasectomy cost once your deductible is paid. If your insurance does not cover a vasectomy, it may be time to shop around for a new health insurance plan that will. SmartFinancial can help you find the perfect plan that fits your budget and lifestyle. By entering your zip code below and answering a few questions, you will receive free health insurance quotes.
Christa Ehrler is a wordsmith, copywriter, and traveler with over seven years of digital publishing experience. She is a storyteller who believes in the power of words.
