Will Insurance Pay for my Vasectomy Reversal?
For most men, a vasectomy reversal is not covered by your insurance. Insurance companies think it is not medically necessary. They do not want to pay for correcting a decision that you now regret.
How to find out
Because there are literally thousands of insurance plans and variations within each plan, you have to call and find out what your specific plan will cover. Call your insurance company, give them your ID number and group number and ask if they will cover and approve an “outpatient microsurgical vasovasostomy” (code # 55400).
You are approved!…maybe
Even if they say that a reversal is covered, it usually is not. It’s one of those fine print things. If they tell you “yes, it is a covered expense,” or that all outpatient surgery is covered, then be sure to record the name, date, and time and employee name and identification number of the person you are speaking with. This is because the department that approves or denies surgery is not the same department that later on writes the check. They may even be in different cities or countries.
In our experience over many decades, when a patient is told that a reversal was “approved,” later on the payment side of the company denied coverage, claiming either the approval was in error (they say read the fine print) or that a prior approval is not binding and that they can refuse payment later on, even after the surgery. Worse yet, they may say okay and send a check for $600 for a $8700 reversal and call that the approved “reasonable and customary” amount. Some insurance plans try to direct you to an “in plan” doctor to do the reversal even if he’s not trained, skilled or experienced.
How ICVR works with you
We are not contracted with any insurance company or government agency. To handle filing hundreds of claims with many months of challenges and battles with companies and plans, all over the US and around the world, we would need a team of many employees – employees hired just to fight for reimbursement, and then up goes the costs. Here at ICVR, you pay for your reversal and then you can apply to your insurance for reimbursement to you. To help you, we provide copies of your operative note and relevant records so that you can submit to your insurance for reimbursement after your vasectomy reversal. Sometimes they will reimburse you part or all of what you paid, though many times they won’t. Sadly, there is no way to know beforehand.
If you have questions, please call our full time, reversal only center at 888-722-2929 or email us at firstname.lastname@example.org.