Insurance Coverage for Your Vasectomy Reversal
Whether or not your insurance will pay for your vasectomy reversal is a common question I hear once or twice a week. For most, sadly the answer is no, a vasectomy reversal is usually not a covered expense.
At this point in time, most insurance plans do not pay for a vasectomy reversal. Why? I personally do not understand. Somehow all insurance companies have decided that it is acceptable to deny you coverage for a vasectomy reversal. It's as if they have the right to punish you because you chose to have a vasectomy years before in the past. Many of these same companies though gladly pay for female fertility or for other elective, non-essential but more politically sensitive care. And with healthcare changes coming that will look at reducing coverage and costs, it is unlikely that vasectomy reversals will be covered in the foreseeable future.
Because there are so many insurance companies in each state, and each state's plans function under different rules and regulations, and each employer has different options, there are literally many thousands of plans. We suggest that you 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). If they tell you "yes, it is a covered expense," then be sure to record the name, date, and time and employee identification number or extension of the person you are speaking with. Sadly, the few times patients have told me their vasectomy reversal procedure was approved, later on the company denied coverage, claiming the approval was in error (read the fine print on page 218 they explained). However, on rare occasions a vasectomy reversal may be covered and so it is worth your time to call and ask.
At ICVR we are not contracted with any insurance company or government agency. To handle the claims, challenges and battles with plans all over the US and around the world, we would need a team of many employees – employees hired just to fight for reimbursement. Hiring these employees would raise the cost of each reversal. We simply could not contract with or handle claims with the thousands of insurance companies and plans. What we do is to provide you copies of your operative note and relevant records so that you can submit for reimbursement after your vasectomy reversal.
Affordable financing for your vasectomy reversal procedure.