Enhance Health

Is a Vasectomy Covered by Health Insurance?

A vasectomy is an effective form of birth control for men. But the procedure can be quite pricey, especially without insurance. 

Health insurance plans can cover a variety of different medical procedures, but is a vasectomy one of them? And how much would it cost with or without insurance? 

We’ll answer these questions and dive into more details about the procedure and its costs below. So, keep reading to learn more about vasectomies, how much they cost, and whether they are covered by health insurance. 

What Is A Vasectomy?

A vasectomy is a male sterilization method with a more than 99% success rate. The surgical technique is usually carried out under local anesthesia. 

The procedure is done in a hospital by a urologist. However, certain qualified general practitioners knowledgeable about vasectomies may also conduct it. 

The procedure is quick and only takes about 15 to 20 minutes.

During a vasectomy, physicians cut the sperm tube after injecting a local anesthetic into each side of the testicle. This stops sperm from getting into the semen. 

There are two main types of vasectomies: Conventional and no-scalpel vasectomy.

Conventional Vasectomy

When performing a conventional vasectomy, physicians will make one or two tiny incisions in the scrotum. This will enable them to access the vas deferens. Then, they cut and extract it in small segments. 

The urologist may cauterize or sear the ends and then bind them with stitches. 

The other testicle will subsequently be treated similarly, either through the original incision or a second scrotal incision made by the doctor.

Once the vas deferens are cut from both testicles, the surgeon uses a few stitches to close the opening in the scrotum. 


In a no-scalpel vasectomy, healthcare professionals puncture a hole on one side of the scrotum. They then locate the vas deferens under the skin and pull it through the hole. 

They will cut and remove an insignificant portion of the vas deferens before reattaching the ends. Then they repeat the same process on the other testicle.

Due to how tiny the puncture holes are, this technique does not require stitches.

After a vasectomy, it is advisable to refrain from any strenuous activity for a few days. The entire healing process shouldn’t take longer than a week though.

It’s also worth noting that this procedure doesn’t stop a man from getting an erection or reaching the point of orgasm. It only prevents the release of live sperm.

What Does A Vasectomy Cost?

The cost of a vasectomy depends on how you’d like to go about doing the procedure. 

Do you want to have a consultation before the procedure, or do you want to walk straight into the process? 

If you choose the former, you’ll need to pay for the consultation and the procedure, whereas the latter only includes the procedure fee.

Without insurance, a consultation trip to the doctor’s office can be between $250 and $300. 

From there, you’ll need to book a day for the procedure. 

The procedure without any sedation is typically around $1000, but for the men who prefer to sleep during the procedure and maybe stay overnight, it may cost around $3000.

In total, expect to pay up to $3,300 for a vasectomy if you’re uninsured.

Some men feel more comfortable seeing the doctor before the procedure, but this isn’t mandatory under normal circumstances. Most hospitals and clinics have online brochures detailing everything you need to know about vasectomy before getting one. 

The only reason for a consultation to be mandatory is if the patients have a history of undescended testicles or take prescription blood thinners. 

Does Insurance Cover The Costs Of A Vasectomy? 

The short answer is yes. Health insurance covers vasectomy procedures, but you may have to visit a doctor who is part of your plan’s network and pay a copay or coinsurance fee. 

Vasectomy procedures are less expensive than many other medical procedures, and you can pay for the procedure over time if you must pay out-of-pocket. However, not everyone has $1000 to have the procedure done. 

So let’s take a look at how the different acts and medical insurance plans could help.

Affordable Care Act (ACA) and Medicaid

Vasectomy coverage is not a requirement under the Affordable Care Act (ACA), but insurance plans must cover other kinds of birth control without any out-of-pocket expenses. 

Under the ACA expansion, only women are eligible for preventative coverage for contraceptives, including sterilization. 

Since they are not compelled to do so by federal law and many states do not consider vasectomy to be a prophylactic operation, they do not cover it. 

Your health plan will determine the procedure’s coverage and deductible fees. Call your plan provider to establish whether a vasectomy gets covered under your Affordable Care Act health insurance plan and the exact treatments it covers.  

State-regulated health insurance plans cover free vasectomies for patients in Illinois, Maryland, New Jersey, New Mexico, New York, Oregon, Vermont, and Washington. 

If you don’t live in one of the states where vasectomy coverage is included, check with your Medicaid plan.


Medicare lists vasectomy as elective surgery and doesn’t cover the procedure. However, your Medicare Advantage plan could be a possible source of coverage. These plans must cover everything your original Medicare does and offer extra protection for things that Medicare doesn’t. 

A vasectomy might be covered, depending on your particular Medicare Advantage plan. Your best bet is to check with your provider to get a better understanding.

Private Health Insurance

You can purchase additional coverage or seek an insurer that covers a vasectomy as one of its covered services during the upcoming open insurance enrollment season. 

If you get a vasectomy as an outpatient procedure, most health insurance companies may pay for it.  Always check with your insurance company to ensure they cover vasectomies under their family planning policies.

No Insurance?

You might have to cover the entire procedure’s cost if your insurance doesn’t cover vasectomies and you don’t obtain supplemental coverage. 

The good news is that a vasectomy costs less than other long-term pregnancy control methods. Female sterilization costs around six times as much as vasectomies. 

Numerous medical practices and clinics also provide payment plans and sliding-scale pricing where you pay according to your income.  

However, depending on your location, certain hospitals and general practitioners may require you to pay a fee upfront. Doing this can be expensive so you may find yourself in a financial pickle. 

To find reliable and affordable insurance plans that suit your needs and financial situation, visit Enhance Health. We can help you find the right plan for your budget to help you cover the costs of medical procedures like a vasectomy. 

Vasectomy Vs. Other Forms Of Birth Control

A vasectomy is the most reliable way of birth control when compared to other well-liked options like the pill and condoms. 

Most men who get a vasectomy have no intention of having kids in the future. The procedure is less invasive compared to sterilization in women.

Fear of the procedure and its potential adverse effects is a significant factor in why men decide against getting a vasectomy. However, a vasectomy is a minimally invasive surgery that only necessitates little recovery time. It seldom causes any long-term problems or negative effects. 

Some common adverse effects include minor soreness, bruising, or swelling. And the uncommon effects are infections, bleeding, and fluid in the testicles. 

In contrast, the side effects of oral contraceptives can range from blood clots to depression, and other serious illnesses They also frequently cause nausea, headaches, irregular periods, and other unpleasant symptoms. 

The advantages of the pill differ from woman to woman, but they can lessen the chance of ovarian cancer, help women have lighter, less painful periods, and clean up acne. 

Condoms, on the other hand, carry the risk of a latex allergy. Their main advantage is that, in addition to preventing pregnancy, they also prevent STIs and AIDS. 

Of all the birth control methods, a vasectomy is the most effective. However, it is not advised if you want to have children in the future. While most vasectomies can be reversed, it doesn’t guarantee that you’ll be able to have a child after the reversal. 

Also note that the longer it’s been since you had a vasectomy, the less likely it is that the reversal procedure will be successful.

Frequently Asked Questions About Vasectomies

How much does a vasectomy reversal cost?

It’s best to consider whether permanent sterilization is something you want to do before getting the procedure. 

But if you change your mind, you can have your vasectomy reversed. 

Vasectomy reversal is expensive and not always successful. The cost ranges from $5,000 to $15,000 and the majority of health insurance providers will not pay for this surgery. 

Furthermore, the success rate varies, especially when performed to restore fertility.

The likelihood of impregnation generally decreases with the length of time between a vasectomy and a vasectomy reversal treatment, and with the female partner’s age.

Will a vasectomy protect me from sexually transmitted diseases?

No. A vasectomy won’t protect you or your partner from sexually transmitted diseases (STDs). 

If you’re sexually active, wear condoms to protect yourself from STDs.

Can I stop taking other birth control after having a vasectomy?

A vasectomy doesn’t immediately prevent conception. 

Once you get the procedure, the sperm might linger in your semen for several months. 

A doctor will check your sperm count about three months following surgery. 

Sex without using another method of birth control may result in pregnancy up until your sperm count is zero or below 100,000. Use a different method of birth control until your doctor can confirm this.

The only method to establish that you don’t have sperm in your semen following a vasectomy is to get a semen analysis. 


Generally, vasectomy is a safer option than tubal ligation or other birth control treatments, like the pill. It also outperforms alternative approaches in terms of price and pregnancy prevention effectiveness.

With insurance, vasectomy costs between $0 and $1,000. The type of insurance you may have, and the location where you get the procedure all affect the fee you’ll pay.  Always double-check these details before making your choice.

If you’re looking for the right insurance plan for you, don’t hesitate to contact us at Enhance Health. We’re here to help you get the coverage you deserve.

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