Medical insurance may pay the costs of reversing a vasectomy in some situations. However, in the vast majority of situations, insurance does not cover the surgery. The initial consultation may be covered, but before scheduling an appointment with one of our doctors, we recommend calling your insurance company to see if your plan covers the treatment.
If your insurance doesn’t cover the surgery, you’ll have to pay for it yourself. We provide a great financing option to help you achieve your dream of having a kid.
Does insurance cover reverse vasectomy?
Dr. Sheldon Marks, a microsurgeon and author, explains how and why insurance rarely pays for a vas reversal in this article.
In the end, most insurance companies will not pay a vasectomy reversal for most men. Insurance companies consider it a cosmetic operation rather than a “medically required” procedure. They refuse to pay for the cost of repairing a mistake that men now regret. Furthermore, an insurance insider told me that a successful vasectomy reversal will increase insurance company costs because they will now be responsible for the birth and costs of additional children with no additional income to cover these costs.
Because there are so many different insurance plans and so many variances within each plan, each patient will need to call their insurance provider to see if their plan covers a “outpatient microsurgical vasovasostomy” (code # 55400-50). It’s recommended not to use the phrases “vasectomy reversal” in your conversation.
Even if the insurance company person claims, “Yes, an outpatient vas reversal is covered,” as they frequently do, realize that this is typically not the case, and they will refuse to pay afterwards. It’s one of those fine print clauses that no one ever reads in their health insurance policy. When they answer “sure, it’s covered,” what they really mean is that outpatient surgery, even with a non-contracted physician, is usually a “covered expense” under the terms of the insurance contract. The difficulty is that despite decades of executing tens of thousands of vasectomy reversals, the insurance company virtually invariably refuses to pay once the surgery is completed. Here’s how they do it: the authorization department that says it’s “covered” isn’t the same one that needs to approve the payment and issue the check afterwards. The payment division then adds that the insurance company is not legally obligated to pay even if “pre-approved.” The patient is now accountable for paying the unexpected bill.
Even if the insurance company or agency “approves” the vas reversal and gives the doctor a check, it may only be a few hundred dollars for a several thousand-dollar treatment, in my experience. The reason for this is that the insurance company gets to pick what is “fair and customary” for a vasectomy reversal in 2021, even if it is thousands of dollars less than the genuine costs. Even if the clinician is not trained, skilled, or experienced in urologic microsurgery, some insurance plans try to steer patients to a “in plan” contracted urologist to do the vas reversal.
No insurance company, corporation, government/military body, or veterans agency has a contract with ICVR. We just cannot afford to engage many more full-time staff to submit and re-file hundreds of claims over and over again, enduring months of problems and disputes with insurance companies in the United States and around the world. Instead, we’ve discovered that it’s easier for the patient to pay for the vas reversal up front and then request for reimbursement from the insurance provider. To aid in this procedure, we supply a copy of the operative note.
We also provide payment options for most couples because we understand that a well-performed microsurgical reversal vasectomy is not inexpensive.
Sheldon H. F. Marks, MD reviewed, revised, and updated this page on January 1, 2022.
How much does a reversal of a vasectomy cost?
The average vasectomy reversal cost at ICVR is $8700, with success rates as high as 99.5 percent. Other doctors’ vas reversals can cost a lot less, while others can cost a lot more. The trick is to inquire as to why and what they forego in order to be so much less expensive.
The goal of this page, written by Sheldon Marks, MD, is to explain how much a vasectomy reversal will cost in 2022 and what each patient will get for that money, which varies greatly from doctor to doctor. It’s crucial to remember that the end goal is a baby, not a vasectomy reversal. Cutting corners or performing rapid reversals may work for some, but there are likely to be other issues and risks, such as decreased success rates.
Cost, as taught to me by my father many years ago, is the amount of money spent on a product or service, whereas value is what each person gets for their money. Too often, people just consider their out-of-pocket expenses and do not consider what they receive or do not receive in return. They make the error of assuming that the cheapest doctor is also the best, and that all doctors provide the same outcomes, success, and care.
One of the most frequently asked inquiries is, “How much does a vasectomy reversal cost?” The cost of reversing a vasectomy can range from $800 to more than $70,000. Most major urologic doctors estimate that the treatment will cost between $8000 and $15,000, with a few as high as $70,000, all for the same procedure with similar outcomes. Several experts who care for vas reversal failures believe that many discount doctors have lower reversal success and higher rates of complications because of their quickie, high volume approach, no or minimal follow-up care, the use of older and simpler techniques (that allow the doctor to go fast), or not having critical support and OR staff, according to a recent fertility society meeting. Many doctors, we’ve heard, send out unexpected invoices weeks or months after the reverse vasectomy surgery.
For a routine, first-time vasectomy reversal for fertility, we offer a fixed, all-inclusive price package of $8700 with no hidden charges or unexpected fees. More difficult vasectomy reversals, redo vasectomy reversals, or vasectomy reversals for the treatment of post-vasectomy pain syndrome cost more (PVPS).
Because the doctors of ICVR are regarded as leading authorities by so many top tier doctors, and because we wrote the textbook (1) published articles, and taught the classes and courses to other doctors, every patient can expect the highest chances for vas reversal success, with vas-to-vas connections having a success rate of up to 99.5 percent (2). Many other doctors, sadly, believe they are doing a fine job with a vas reversal success rate of 70, 80, or 90 percent.
This cost remains the same for patients at ICVR, regardless of whether the vas reversal takes longer than the usual 2 to 3 hours or whether we need to conduct the more intricate and difficult vas-to-epididymal bypass (vasoepididymostomy, VE) on one or both sides.
Are Vasovasostomy covered by insurance?
Medical insurance may pay the costs of reversing a vasectomy in some situations. However, in the vast majority of situations, insurance does not cover the surgery. (1)…
The author discusses vasovasostomy, a surgery that reattaches the vas deferens tubes after a vasectomy. What to expect following surgery and how well it went (2)…
Insurance may cover the costs of a vas reversal in some situations, but it does not in the vast majority of cases. We recommend that you contact your insurance provider (3)…
Does insurance pay for second vasectomy?
Recap. The expense of a vasectomy is frequently covered in full or in part by health insurance. However, you should double-check your plan for specifics. It’s also worth noting that if you desire to reverse a vasectomy later, your health insurance may not cover the fees.
Are vasectomy reversals successful?
If you had your vasectomy less than 10 years ago, your chances of being able to generate sperm in your ejaculate again after a vasectomy reversal are 95 percent or higher. The success percentage is lower if your vasectomy was performed more than 15 years ago. Pregnancy rates vary greatly, ranging from 30 to more than 70% in most cases.
Can a vasectomy be reversed naturally?
According to a 2018 study, little over 7% of persons who have undergone a vasectomy later regret their decision. Vasectomies, fortunately, are typically reversible.
The vas deferens is reconnected during a vasectomy reversal treatment, allowing sperm to enter the sperm. However, because this is a more involved and demanding treatment than a vasectomy, it’s critical to choose a knowledgeable surgeon.
- Vasovasostomy. Using a high-powered microscope to inspect the small tubes, a surgeon reattaches the two ends of the vas deferens.
- Vasoepididymostomy. The top end of the vas deferens is connected to the epididymis, which is a tube in the back of the testicle, by a surgeon.
When surgeons begin the procedure, they usually decide which strategy will work best, and they may use a combination of the two.
Are vasectomies 100 reversible?
Vasectomies can almost always be reversed. However, this does not guarantee that you will be able to conceive a kid. Vasectomy reversal can be tried even if it has been several years since the original vasectomy, but the longer it has been, the less likely the reverse will be successful.
How can I have a baby if my husband had a vasectomy?
Vasectomy is becoming one of the most popular sterilization procedures in the United States. If you change your mind about having children after your vasectomy, there are two treatments that can let you have a kid with your partner. A vasectomy reversal or sperm aspiration prior to in vitro conception are the two alternatives (IVF). Your doctor can advise you on which technique is best for you and your partner depending on the following factors:
What are the first steps I should take?
The first step is to consult a urologist. A urologist is a physician who focuses on the medical treatment of a man’s reproductive organs. Your urologist will review your medical history and do a physical check to ensure that you don’t have any other health problems that could influence your fertility. Your partner should also see a doctor to ensure she is not suffering from infertility.
What happens in a vasectomy reversal procedure?
Vasectomy reversal techniques are divided into two categories. The procedure employed is determined by whether part of the male reproductive system was blocked during your vasectomy.
- The two ends of the vas deferens are connected by a vasovasostomy (vas-o-vay-ZOS-tuh-me). The vas deferens is a tube that transfers sperm from the testes out of the body. On both the right and left sides of the scrotum, you have two vasa deferentia. During your vasectomy, each of your vasa deferentia was cut to prevent sperm from mingling with semen.
- The epididymis is connected to the vas deferens by a vasoepididymostomy (vas-o-ep-ih-did-ih-MOStuh-me). The epididymis is a coiled portion of the sperm ducts that matures sperm. When a vasovasostomy is not possible due to obstructions produced by the vasectomy, this operation is used.
During the operation, your doctor will choose which procedure is best for you. Both methods of vasectomy reversal offer the potential to allow you and your partner to have a child naturally through sexual activity.
How is sperm aspirated prior to an IVF cycle?
Your doctor aspirates (gently suctions) sperm from your testicles during this surgery. This technique is commonly done in the office under local anesthesia (with numbing medication). It’s also possible to do it under general anesthesia (when you are put to sleep). A tiny needle is used to extract sperm from each vas deferens near the testicle, or possibly from each testicle itself. After this treatment, most men experience some little discomfort.
The sperm is then used in a laboratory to fertilize your partner’s eggs through IVF. The sperm can be aspirated on the day of the IVF operation or retrieved ahead of time and preserved for a later IVF procedure. The use of sperm for artificial insemination is not suggested due to the tiny quantity of sperm.
When combined with IVF, this approach is quite effective, especially if your spouse is under 35 years old. This approach also has a number of other advantages. It’s possible that it’ll take your partner less time to become pregnant, and you won’t need to use birth control following a successful pregnancy. For the male partner, it is also a less invasive procedure. There are a few drawbacks as well. It is more costly. Your partner may have more than one child at the same time if more than one embryo is transferred. It’s also a more invasive process for the female spouse, and you might have to repeat it if you want more children.
What is the success rate of a vasectomy reversal after 10 years?
If you have a desk job, you can return to work in a day or two. If you have a more demanding project, you may be able to complete it in three or four days. It’s also a fairly safe surgery, with bleeding and infection risks of less than 0.5 percent.
Your testicles never stopped making sperm
Many guys are surprised by this, according to Dr. Vij. Your testicles, on the other hand, continue to make sperm after a vasectomy. It simply can’t get out of the body anymore.
A reversal restores your natural fertility as a result of this. You’ll be asked to refrain from sexual activity for three weeks or so to allow your body to heal, after which you can begin trying to conceive. (It can take up to 12 months for fertility to return in some cases where the epididymis (the coiled tube along the testicle where the sperm matures) is blocked.
Time is a factor (but not the only one)
It’s a frequent myth that if a man had a vasectomy years ago, he won’t be able to reverse it. “That isn’t always the case, according to Dr. Vij. “The period since the vasectomy has a big impact on the success rate.” If the vasectomy was performed within the last ten years, the success rate can be as high as 95%. When a man has had his vasectomy for 15 years, they begin to deteriorate.
Even after a successful reversal, a number of factors will influence your chances of becoming pregnant. The age of the female partner, as well as the health of the man’s sperm, are essential considerations.
What is cheaper vasectomy reversal or IVF?
When couples visit a fertility center or receive a referral from the wife’s OB/Gyn, they may be advised to try In Vitro Fertilization (IVF) first rather than vasectomy reversal. This can be perplexing for many patients.
Not only is vasectomy reversal less expensive than IVF, but it also saves the couple time and energy if the female spouse has no infertility difficulties.
It’s also the most natural and enjoyable way to have a child.
According to studies, having a child via IVF is often two to three times more expensive than vasectomy reversal.
According to one study published in the Journal of Urology Clinics of North America in August 2009, vasectomy reversal is “the gold standard,” and it is the physician’s responsibility to present patients with all options, including cost, in order to help them make an informed decision when advising them on infertility treatments in this era of cost containment.