How Much Is a Vasectomy, and Does Insurance Cover It?
The average cost of a vasectomy is $1,730.
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You might pay more or less depending on your health insurance and state laws.
The cost of a vasectomy depends on your insurance, the procedure you choose and your state's laws. 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 $1,730 before insurance.
How much you pay for a vasectomy depends on your insurance, where you live and the doctor and the type of procedure you choose. For example, it's usually much cheaper to get a vasectomy at a same-day surgery center than to get the same procedure at a hospital.
The total cost of a vasectomy comes from several different services.
- The first doctor visit
- The vasectomy procedure
- Medication
- Follow-up visits and procedures
Vasectomies work 99% of the time.
Vasectomies are effective, safe and quick, according to Cleveland Clinic. Full recovery typically takes about 10 days.
Vasectomy cost with health insurance
Vasectomies cost $345 after insurance, on average.
If you go to a same-day surgery center, you'll pay an average of $236 for a vasectomy with insurance. At a hospital outpatient center, vasectomies cost an average of $454 if you have health insurance.
Keep in mind, these are average figures, and many insurance plans cover the full cost of a vasectomy. That means your vasectomy could be free, depending on your health insurance.
Some plans may cover the entire procedure. But other plans might require you to meet your health insurance deductible before your coverage starts. You may also have to pay other costs when you go to the hospital or get a medication filled, called copays and coinsurance.
Does health insurance cover vasectomies?
Health insurance will often cover vasectomies, but it depends on where you live and your plan details.
The Affordable Care Act (ACA) requires health insurance companies to cover 10 types 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 don't have to cover the cost of a vasectomy at the national level. But some states require that health insurance covers vasectomies.
Check your state laws and talk with your insurance company to find out what kind of coverage you have.
States that require health coverage of vasectomies
Vasectomy cost with Medicare
Original Medicare (Parts A and B) does not cover vasectomies.
It's possible that you could get vasectomy coverage with a Medicare Advantage plan. But it's not a commonly offered service. Check your plan details to see if you have coverage for this service.
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 41 states that responded to a survey from KFF. Washington, D.C., residents also have vasectomy coverage under Medicaid.
Vasectomy reversal costs
A vasectomy reversal usually costs between $5,000 and $15,000, according to Planned Parenthood.
You may be responsible for other costs if you want to have a child in the future. Freezing your sperm costs roughly $1,000, and you'll pay another $250 to $500 per year to store it.
Health insurance plans don't usually cover vasectomy reversals because they're considered an optional procedure. Your insurance is more likely to cover a vasectomy reversal if you can prove that you need it for medical reasons.Vasectomy costs you pay with insurance
Even if your insurance covers vasectomies, 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 pay a certain amount of money first, called a deductible. For example, if you have a $2,500 deductible, your health insurance might not cover your vasectomy until you've paid $2,500 for medical care this year.
- Copays for office visits: Many health insurance plans charge flat fees called copays for doctor visits.
- Coinsurance: Coinsurance is a percentage of your medical bill that you pay after you meet your deductible. 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 differ depending on a few other factors.
- The doctor you see: Depending on the type of health insurance you have, you might need to use an in-network doctor. Some plans will let you use a doctor outside your network at a higher cost.
- The type of vasectomy you get: There are two types of vasectomies: those done with a scalpel and those done without a scalpel. Although these procedures tend to have similar costs, the clinic you go to may charge slightly more for one versus the other.
- Where you get your vasectomy: Typically, procedures done in a doctor's office or surgery center cost less than those done in a hospital.
Your doctor will help you decide what type of vasectomy to get and where to go for your procedure.
How to pay for a vasectomy
The best way to pay for a vasectomy is to save for your procedure and take advantage of payment plans.
- Plan ahead and save: If you know you want to get a vasectomy, you could try to save with a special account that lowers the amount you pay in taxes, like a health savings account (HSA) or flexible spending account (FSA).
- Ask about a payment plan: Some doctors and clinics offer payment plans. If you earn a low income, you may qualify for a discounted procedure using what's called a sliding scale fee.
Remember that vasectomies last for the rest of your life (unless you get the procedure reversed). It's a good idea to compare the full cost of a vasectomy to what you or your partner would pay for birth control over the coming years. Although vasectomies have a high upfront cost, you may save money over the long run.
Frequently asked questions
How much does a vasectomy cost with insurance?
Vasectomies cost $1,730, on average. With insurance, you'll pay an average of $345.
Is a vasectomy fully covered by insurance?
Many health insurance companies cover all or most of the cost of a vasectomy. Keep in mind that coverage will depend on where you live and your plan details.
Where can I get a vasectomy?
You can get a vasectomy at hospitals, clinics and neighborhood health centers like Planned Parenthood. If you have insurance, try to find a doctor in your network to avoid paying high costs when you get care. You may also need a referral from your primary care doctor if you have an HMO (health maintenance organization) plan.
Sources
The average cost of a vasectomy came from 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.
Other sources for this article include the American Urological Association, the Centers for Disease Control and Prevention (CDC), Planned Parenthood, KFF and Mayo Clinic. Arkansas, Georgia, Kentucky, Minnesota, Nebraska, New Hampshire, New Mexico, Ohio and South Dakota 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.