How Much Is a Vasectomy, and Does Insurance Cover It?
The average cost of a vasectomy is $1,580. You may pay more or less depending on your health insurance and state laws.
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The cost of a vasectomy varies depending on your insurance coverage, the type of procedure you have and your state's laws. A vasectomy prevents pregnancy by cutting off the flow of sperm. Vasectomies are intended to be permanent, but reversal is possible. The cost to reverse a vasectomy is usually higher than the cost of the original procedure.
How much does a vasectomy cost?
A vasectomy costs an average of $1,580 before insurance coverage.
Pricing varies depending on your insurance, the state you live in, how your doctor's office prices the procedure and the specifics of your procedure. For example, a vasectomy performed in a surgery center costs an average of $1,077, while a vasectomy at a hospital costs $2,084, on average.
The American Urological Association says that vasectomies are effective, safe and noninvasive. The Centers for Disease Control and Prevention (CDC) lists vasectomies as outpatient procedures, which means you can usually go home the same day.
The cost of a vasectomy is broken into different parts.
- The initial visit
- The vasectomy itself
- Numbing medication
- Follow-up semen analysis
Vasectomy cost with health insurance
Many health insurance companies cover the cost of a vasectomy, even if it's not required by law.
If you have health insurance coverage for a vasectomy, the procedure could be free or cost you very little. It all depends on how your policy is set up. Your plan might cover the entire procedure, or you might have to meet your health insurance deductible first. You may also have copayments and coinsurance fees.
The Affordable Care Act (ACA) requires that health insurance companies cover 10 categories of health care services, including preventive care. Birth control is considered preventive, but only for women.
Vasectomies are a type of birth control for men. This means that health insurance companies aren't required to cover the cost of a vasectomy, unless state laws require it, even though they are required to pay for women's contraception, including sterilization for women.
Several states, including Illinois, Maryland and Oregon, require that health insurance companies cover vasectomies with no cost to you. Checking your state laws and talking with your insurance company are the best ways to find out what kind of coverage you have.
Vasectomy cost with Medicare
Original Medicare does not cover vasectomies.
Medicare Part A covers hospital costs, and Medicare Part B covers outpatient care, such as doctor visits. But vasectomies are elective surgeries, so Original Medicare doesn't cover them.
Medicare Advantage plans work differently. They bundle together Medicare Parts A and B, and they offer perks that Original Medicare doesn't. Each health insurance company gets to decide what coverage perks are offered. It's possible that you could get vasectomy coverage with a Medicare Advantage plan.
Vasectomy cost with Medicaid
Medicaid covers vasectomies in most states.
If you're eligible for Medicaid, the best way to find out if a vasectomy is covered is to contact the Medicaid agency in your state.
Medicaid covers vasectomies in all 40 states that responded to a survey from the Kaiser Family Foundation. Washington, D.C. residents also have vasectomy coverage under Medicaid.
Vasectomy reversal costs
A vasectomy reversal costs an average of $2,850, but costs vary widely.
Vasectomies can be reversible, but the reversal is more expensive than the original procedure. Mayo Clinic reports that a vasectomy reversal can cost as much as $16,000 if general anesthesia is used. Even with a local anesthetic, costs can go as high as $6,000. Other fees can apply on top of the cost of the procedure, making the out-of-pocket cost even higher.
Health insurance plans don't usually cover vasectomy reversal. The procedure isn't typically covered by Medicare or Medicaid, either. If you can prove that a reversal is medically necessary, you may be more likely to have your reversal covered.
Vasectomy cost considerations
Even if your vasectomy is covered by insurance, you might still have to pay for some of the costs.
- Deductible: Your health insurance plan might cover your vasectomy completely, or you might have to meet your deductible first. For example, if you have a $2,500 annual deductible, your health insurance might not cover your vasectomy until you've paid $2,500 of your own medical costs out of pocket in that year.
- Copays for office visits: Many health insurance plans charge flat fees called copays for office visits. This means your initial consultation, the vasectomy itself and any follow-up visits might come with an office fee.
- Coinsurance: Coinsurance kicks in after you've met your deductible, and it's structured as a percentage. For example, your insurance company might pay 80% of your health care costs after you meet your deductible, and you'll pay 20%.
- Out-of-pocket maximum: This is the most you'll pay in a calendar year for your health care costs. Once you meet this amount, you won't pay for any covered health care services.
Some insurance plans might cover vasectomies completely, which means you won't pay anything.
Vasectomy costs can also vary depending on a few other factors.
- The health care provider you use: Depending on the type of health insurance you have, you might have to use an in-network doctor to have any coverage for your vasectomy. You might be able to use a nonnetwork doctor, but you'll probably pay more.
- The type of vasectomy you get: There are two types of vasectomies: those done with a scalpel and those done without a scalpel. The costs for each type might vary, and your doctor will help you choose a type of vasectomy.
- Where you get your vasectomy: Typically, procedures done in a doctor's office or surgery center are cheaper than those done in a hospital setting. Your doctor can help you decide where it's best for you to have your vasectomy.
How to pay for a vasectomy
If your health insurance doesn't cover your vasectomy or you will still have out-of-pocket costs, you can use a few strategies to help cover the expense.
- Do some math: Vasectomies can be reversed, but they are designed to be permanent. Comparing the cost of a vasectomy against the cost of other forms of birth control might help you decide if it's the right choice. Even though it might be more expensive than other types of birth control, it's a one-time fee that protects against pregnancy for the rest of your life.
- Plan ahead and save: If you know you want to get a vasectomy, you could try to save for the out-of-pocket costs before your procedure. You can also pay for a vasectomy from a health savings account (HSA) or flexible spending account (FSA).
- Ask about a payment plan: Some doctors and clinics offer payment plans. You might even be able to arrange payment based on how much you make. This is called a sliding scale fee, and it usually means that low income patients pay less.
Frequently asked questions
How much does a vasectomy cost out of pocket?
The average vasectomy cost is $1,580 before insurance is applied. The cost of a vasectomy can vary based on your health insurance, what type of procedure you get and where you have the vasectomy done.
Is a vasectomy covered by insurance?
Many health insurance companies cover vasectomies even if they aren't required to by law. The amount of coverage will vary depending on your insurance company and your specific plan.
How do I find vasectomy doctors near me?
Ask your primary care doctor for a referral to a urologist. Many reproductive care clinics also do vasectomies. You could also research urologists in your area. Look for someone who is board certified and lists vasectomies as one of their specialties.
Sources
The average cost of a vasectomy was sourced using the Procedure Price Lookup tool on Medicare.gov using the Current Procedural Terminology (CPT) medical billing code 55250. Vasectomy reversal costs used the billing code 55400. Actual costs will vary based on your procedure and health insurance coverage.
Other sources for this article include the American Urological Association, the Centers for Disease Control and Prevention (CDC), the Kaiser Family Foundation (KFF) and Mayo Clinic. Florida, Kansas, Louisiana, New Jersey, North Dakota, Pennsylvania, Rhode Island, South Dakota, Utah and Wisconsin did not respond to the KFF survey about Medicaid coverage and were excluded from the state-level analysis of family planning services.
Editorial note: The content of this article is based on the author’s opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.