Does Medicare Cover a Vasectomy?
Last Updated : 09/12/20183 min read
If you’re a male Medicare beneficiary who wants to make sure he doesn’t cause a pregnancy, you might be wondering about Medicare coverage of a vasectomy. A vasectomy is almost 100% effective at preventing pregnancy, according to Planned Parenthood. However, Original Medicare, Part A and Part B, typically doesn’t cover a vasectomy.
What is a vasectomy?
According to Planned Parenthood, a vasectomy is a simple outpatient surgery. During a vasectomy the small tubes that carry sperm are cut or blocked off. The vasectomy prevents sperm from leaving the body. A vasectomy could be done with an incision or the non-scalpel method. With an incision vasectomy the doctor makes small cuts in the scrotum (the sac of skin that holds the testicles). With a no-scalpel vasectomy the doctor makes a tiny puncture to reach the tubes in the scrotum. The tubes may be tied off, cauterized or blocked. A vasectomy is not an operation on the penis.
Does Medicare Advantage cover a vasectomy?
If you’re enrolled in a Medicare Advantage plan, you get your Medicare Part A and Part B benefits through this private plan. Medicare Advantage plans are required to cover at least the same level of benefits as Original Medicare with the exception of hospice care, which is still covered by Medicare Part A. The plan might have additional benefits that Original Medicare doesn’t include, such as routine vision services or prescription drugs. You can ask your Medicare Advantage plan if it covers a vasectomy. If you have a Medicare Supplement plan, this private insurance policy might cover certain Original Medicare out-of-pocket costs like copayments and deductibles but Medicare Supplement does not generally cover vasectomy costs. .
Are there other ways to get coverage for a vasectomy?
You might want to ask your doctor about other forms of sterilization or birth control. Although Original Medicare generally doesn’t provide this coverage, your health-care provider might be able to recommend an inexpensive alternative. Also, some state Medicaid programs may cover family planning services. Although there is no requirement that Medicare covers contraceptives, some Medicare Part D Prescription drug plans may cover them.
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