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.
Can you make payments on vasectomy reversal?
CareCredit is a medical credit card that can help you pay for out-of-pocket medical expenses. The CareCredit card has a number of key features, including:
- CareCredit offers customized financing alternatives to help people spread out their medical bills rather than paying them all at once.
- Short-term financing alternatives from 6 to 24 months are available through CareCredit. If you make your minimum monthly payments and pay the entire amount owing by the end of the promotional term, you will not be charged interest on purchases of $200 or more.
- Patients utilize the CareCredit card to pay off their Chesapeake Urology bill in full and then make monthly payments to CareCredit, much like they would with a personal credit card.
How much does a reverse vasectomy cost without insurance?
Is it possible to undo a vasectomy? Yes, it’s conceivable. Only 6% of the 500,000 men who have a vasectomy each year choose to have the procedure reversed. However, re-establishing the sperm channel is more difficult than re-establishing a Wi-Fi connection.
The reversal of a vasectomy is a safe surgery. However, getting unsnipped can be costly.
It’s crucial to understand what a vasectomy is before we get into the details of a reversal.
A vasectomy is a simple outpatient procedure in which the vas deferens (tubes that carry sperm) of a man is severed, preventing sperm from mixing with semen after ejaculation. With only a 0.4 percent failure rate, it’s considered a permanent kind of birth control.
As a result, you should be sure you don’t want any more children before obtaining a vasectomy. Situations, however, change. The majority of men opt for a vasectomy reversal because they were snipped while they were young (under 30), remarried after a divorce or the death of their spouse, or changed their thoughts about having children.
While a vasectomy is a minor procedure, a reversal is a substantial one. Here are some distinctions between the two:
- A vasectomy takes roughly 20 minutes, but the reverse surgery can take anywhere from 2 to 5 hours.
- A vasectomy is frequently covered by insurance and costs less than $1,000. Reversals can cost anywhere from $5,000 to $12,000 and are rarely reimbursed by insurance.
- Both treatments have the potential for side effects, but reversals carry a higher risk of fluid buildup in the scrotum and artery and nerve harm.
Vasectomy reversal surgery can be divided into two categories. The most common is a vasovasostomy, in which the surgeon examines the vas deferens through an incision in the scrotum near where the vasectomy was performed.
To check for sperm, the surgeon takes fluid from the end of the vas. The ends of the vas deferens are rejoined if there is sperm.
If sperm isn’t present, the surgeon will conduct a vasoepididymostomy to clear the blockage in the epididymis. It’s a little more difficult because it requires attaching the tubes to the epididymis.
A vasectomy reversal’s success is judged in two ways: patency and pregnancy.
Patency is the process of effectively reopening the vas deferens so that ejaculation contains enough sperm. After the reversal procedure, the guy successfully gets his partner pregnant, which is known as pregnancy.
Pregnancy success rates are around 75%, while success rates reduce if you have a reversal more than 15 years after your vasectomy.
It is possible to have a vasectomy reversed, and many men have had children as a result of the treatment. But keep in mind that it’s not as simpleor as inexpensiveas a vasectomy. So, before you decide to have your hair trimmed, be sure you’re certain.
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)…
What percentage of vasectomy reversals work?
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.
Why does it take 3 months for sperm to return after vasectomy reversal?
Because it takes 3 to 6 months for the testicles to create fresh sperm, sperm quality should return to normal 3 to 6 months after a reversal. However, due to partial obstruction or scarring, the count and motility may be reduced after reversal.
Can a vasectomy be reversed after 15 years?
New York, New York (19 February 2004) A recent study by physician-scientists at NewYork-Presbyterian Hospital/Weill Cornell Medical Center debunks a prevalent myth about vasectomy, finding that vasectomy reversal is very effective even 15 years or more after the vas deferens, the tube that delivers sperm, is closed. The study, which was published in the Journal of Urology in January, found the greatest pregnancy rates after vasectomy of any study to date.
The study found that whether a man had a vasectomy this year or 15 years ago, the pregnancy rate following a vasectomy reversal was the same, with an average of 84 percent risk of pregnancy over two years. (In comparison, healthy men who do not had a vasectomy can expect a pregnancy rate of 90%.) Pregnancy rates following vasectomy reversal were only 50-60% in previous research, a difference that can be linked to breakthroughs in vasectomy-reversal methods. The study also discovered that the pregnancy rate plummeted to 44% at intervals of more than 15 years.
“Vasectomy is a non-permanent procedure. A reversal will result in a substantially greater pregnancy rate than sperm aspiration and in vitro fertilization (IVF) with intracytoplasmic sperm injection for males who had a vasectomy less than 15 years ago (ICSI). Even at intervals of more than 15 years, reversal results will be on par with or better than IVF with ICSI “Dr. Marc Goldstein, the study’s lead author and Surgeon-in-Chief of Male Reproductive Medicine and Microsurgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, states At the best centers, IVF with ICSI can result in pregnancy rates of up to 50% per attempt, albeit it may take two or three tries to get pregnant.
“Vasectomy reversal is also a more cost-effective alternative, particularly for couples who want more than one child,” Dr. Goldstein says. “IVF with ICSI is often two to three times more expensive than vasectomy reversal. In several states, including New York, a reversal is covered by health insurance, unlike IVF with ICSI.”
According to Dr. Goldstein, men desire to reverse a vasectomy for two reasons: remarriage or the loss of a child. In the United States, around half a million vasectomies are performed each year, with an estimated two percent to six percent of men seeking reversal.
Between 1984 and 2001, 213 vasectomy reversals were performed at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, according to the report. The results were divided into four groups based on the length of the obstructive interval: less than 5 years, 5-10 years, 10-15 years, and greater than 15 years. The study only looked at men who had reproductive female partners.
The study also discovered that the vas deferens’ patency (or absence of obstruction) remained high for up to 15 years, averaging 90% and remaining constant regardless of when the vasectomy was performed. Other study results contradict this conclusion, which could be explained by the recent advent of superior surgical procedures for vasectomy reversal. Dr. Goldstein pioneered one such approach, the microdot method for precision suture application, in 1998.
Another myth about vasectomy is that the existence of granulomas, which are knots that form in the vas deferens when a vasectomy is done too tight, leads to increased patency and pregnancy rates. Granulomas, which occurred in 28% of vasectomies, did not increase patency to a statistically significant level and had no effect on pregnancy, according to the current study.
The study is the first to look at pregnancy and patency after two different types of vasectomy reversals: vasovasostomy (VV) and vasoepididymostomy (VE). Patients who had bilateral VV had a significantly higher patency rate (95%) than patients who had unilateral VV and VE (83%) and bilateral VE (83%) respectively (83 percent ). Pregnancy rates, on the other hand, were steady.
Vasovasostomy (VV) is a procedure in which the vas deferens is reconnected to the vas deferens. The vas deferens is connected to the epididymis, a duct that transports sperm to the vas deferens. Vasoepididymostomy (VE) connects the vas deferens to the epididymis, a duct that transports sperm to the vas deferens. If sperm is found in the vas fluid, VV is usually done. VE is used if there are no sperm in the vas fluid. Both procedures are performed in the outpatient setting and require less than three hours.
According to Dr. Goldstein, assisted reproductive methods such as intrauterine insemination (IUI) or IVF with ICSI are the next step for men who are unable to conceive after VV or VE.
Dr. Stephen Boorjian, a urology resident at NewYork-Presbyterian Hospital/Weill Cornell, and Michael Lipkin, a medical student, are co-authors of the study.
Dr. Goldstein and his colleagues at the Center for Male Reproductive Medicine and Microsurgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center have been recognized as leaders in the field of male reproductive surgery and have garnered awards for their educational DVDs. They won the “Audio-Visual Award” (first prize) from the American Urological Association in 2003 for “Ultra-Precise Multilayer Microsurgical Vasovasostomy: Trick of the Trade.” Their “Three Techniques of Microsurgical Intussusception Vasoepididymostomy: Cost-Effective Options for Obstructive Azoospermia: Cost-Effective Options for Obstructive Azoospermia” got the American Society for Reproductive Medicine’s “Best Video Award” in 2002.
How long does it take to get pregnant after vasectomy reversal?
It’s critical to know what’s achievable and comprehend the realities when it comes to getting pregnant following a vasectomy reversal.
Conceiving Is A Process
Getting pregnant after a vasectomy reversal might take anywhere from six to twelve months. It’s vital to remember that a man’s sperm reserve is replaced every three to four months. It can take a number of sperm reserve flips, or about six to nine months, after a vasectomy reversal before sperm count returns to a level where getting pregnant is optimal. It may take another six months or more for a couple to conceive at this time.
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.