When performed for medically essential reasons, most local BCBS plans pay the costs of adult circumcision. In New York, New Jersey, and most other states, circumcisions performed for religious, aesthetic, or hygienic reasons are often not covered by Blue Cross policies.
Does insurance cover circumcision?
Circumcision and circumcision revision for aesthetic, sanitary, or religious reasons are considered “cosmetic” procedures and are not covered by health insurance.
Does insurance cover circumcision for adults?
Adult circumcision (or cosmetic circumcision) is often not covered by health insurance plans unless it is medically necessary. Adult circumcision costs typically range from $1500 to $3,000, depending on the geographic region, type of anesthesia used, and the provider’s skill.
Does Anthem Blue Cross Blue Shield cover circumcision?
All individual and family plans now include coverage for maternity care, according to the Affordable Care Act. These new health services, many of which are offered at no cost to the patient, are also available to newborns. Coverage for routine neonatal circumcision is prominent in many private health policies.
Routine male infant circumcision is a covered benefit
In general, the member’s Evidence of Coverage (EOC) document from the health plan contains all of the rules, covered health care services, and exclusions. While some EOCs are fairly explicit on newborn circumcision coverage, others are either lacking of information or, worse, open to interpretation.
Private health insurance specifies circumcision
Routine infant circumcision is notably mentioned as a covered benefit in the EOCs for Anthem Blue Cross, Blue Shield of California, and Health Net’s individual and family plans. In the EOCs I looked at, Blue Shield and Health Net didn’t indicate the gender of the baby who can be circumcised.
Blue Shield of California PPO EOC
6) Routine infant circumcision in an outpatient setting within 18 months after birth.
**Circumcisions are covered when medically necessary for Covered Persons aged 31 days and older “Surgery and Services for Outpatients.” Please refer to the “For applicable Copayments and Coinsurance, see the “Outpatient Surgery and Services” section.
Health Net HMO EOC
*** Circumcisions for members 31 days and older are covered under outpatient surgery when medically necessary. Copayments for other professional services and outpatient hospital services are included under “Other Professional Services” and “Outpatient Hospital Services,” respectively.
Anthem PPO EOC
Routine nursery care for the Newborn during the mother’s typical Hospital stay, including circumcision of a covered male Dependent and genetic disease screening of a Newborn delivered under a law or regulation-mandated program;
Circumcision missing from some health plans
Circumcision is not a covered benefit for other health insurance providers and health plans participating in the Covered California exchange for individual and family policies. In member agreements or EOCs for Kaiser, Western Health Advantage, and Chinese Community Health Plan, I found no reference of routine infant circumcision. That doesn’t rule out the possibility of circumcision being covered under those policies.
Medi-Cal won’t cover circumcision
Contrary to private health individual health insurance, the Managed Health Care HMO plans provided to current and expanded Medi-Cal participants make it plain that circumcision is not a covered benefit. In other words, if the parents of a child enrolled in a Medi-Cal (Meidcaid) health plan want their infant son circumcised for non-medical reasons, they will be responsible for the entire cost of the treatment. The health plan will not cover the cost of circumcision for the practitioner.
Medically necessary versus cosmetic surgery circumcision
Circumcision will only be covered if it is medically required, according to all commercial and public health plans that serve Medi-Cal members. There are times when a newborn baby boy’s foreskin needs to be medically removed or fixed to correct an anomaly. Circumcision is, in many ways, seen as cosmetic surgery.
Cosmetic surgery (surgical that alters or reshapes normal body structures to improve one’s look) L.A. Care Medi-Cal member handbook
Prostate cancer prevention
According to a recent study, those who were circumcised had a decreased risk of prostate cancer. Circumcision with prostate cancer: a population-based control study in Montreal, Canada, according to the abstract in BJU International.
Circumcised males had a slightly decreased risk of prostate cancer than uncircumcised men (OR 0.89, 95 percent CI 0.761.04), albeit the difference was not statistically significant. In men under the age of 36, circumcision was found to be protective (OR 0.55, 95 percent CI 0.300.98). A lesser protective effect was reported in men circumcised within 1 year of birth (OR 0.86, 95 percent CI 0.721.04). Circumcision was found to have the largest protective impact in Black men (OR 0.40, 95 percent CI 0.190.86, P-value for interaction 0.02), but no link was established with other ancestral groups.
Our findings add to the growing body of data that circumcision can help prevent prostate cancer, particularly in males under the age of 36, while circumcision before the age of one year may also be beneficial. Only Black males, who have the greatest risk of illness, appeared to benefit from circumcision. More research investigating the effects of circumcision on prostate cancer risk based on ancestry, as well as the impact of circumcision age, is needed.
Prophylactic mastectomies
Adult men may seek circumcision after the age of 30 to lower their chance of prostate cancer, just as many women are opting for a double mastectomy to eliminate their risk of breast cancer. In both cases, individuals who are capable of making an informed decision are reaping the preventive benefits of irreversibly modifying one’s body. Women who are at risk for breast cancer might have a genetic test to check if they have the “breast cancer genes.” Unfortunately for males, no definitive association between intact foreskin and prostate cancer in adult men has been identified, whether through genes or STIs.
Circumcision resources
There are numerous websites available to assist parents in learning more about circumcising their newborn baby boy. The fact that circumcision is a covered benefit under your health plan isn’t always the best incentive to get it done. It would be good for health plans that do include circumcision to help educate moms and fathers about what many people regard as superfluous aesthetic surgery on a newborn who is completely dependent on the health-care system.
Does my health plan cover circumcision?
Downloading the Evidence of Coverage document in pdf format is the quickest way to see if your health plan covers regular infant circumcision. Under Edit> Find>Open Full Reader, select Edit> Find>Open Full Reader. When you search for circumcision and type it into the search box, you’ll get a list of all the pages that contain the term. If circumcision is not listed in the EOC, you can call your health plan to determine if procedure is covered. Some of the EOCs for the various plans are given on my website in the drop down menu of carriers under Health Plans>Individual and Family>. Some providers do not make their EOCs widely accessible online. Please let me know whether your health plan covers “routine baby circumcision” and I’ll update the list.
How much does circumcision cost?
In the private sector, medical male circumcision can cost between R1000 and R4000. As part of the Western Cape Government’s HIV prevention strategy, state-of-the-art medical male circumcision is being provided free of charge by CareWorks and their specialized circumcision partners.
Does insurance pay for baby circumcision?
- Circumcision for a newborn infant costs $150-$400 for the doctor and maybe an additional facility fee, bringing the total to $800 or more for patients without health insurance. Gentle Circumcision in California, for example, charges $150 to circumcise kids under the age of seven weeks. In Washington state, Pediatrics Northwest costs $170. In Iowa, Pediatric Associates charges $250. Circumcising newborns up to two weeks old costs $300 at Premier Pediatrics in North Carolina. In Utah, Canyon View Medical Group costs $343. A hospital facility fee of $100-$400 or more can be added to the overall cost if the treatment is conducted in a hospital after birth rather than a physician’s office. Community Memorial Hospital in Ohio, for example, charges a circumcision facility fee of $138. Knox Community Hospital in Ohio, on the other hand, levies a $227 facility fee. A $400 facility fee is also charged by the University of North Carolina Hospitals.
- Circumcision for an older child or adult male often costs $800-$3,000 or more for those without health insurance. Gentle Circumcision, for example, charges $850 for children aged 1 to 17, $1,500 for adults under local anaesthetic, and $3,000 for adults under general anesthesia. For a total of $2,000, Harold Reed, M.D. costs $250 for an initial consultation and $1750 for surgery, which includes doctor fees, anesthetic, and facility fees. The Circumcision Center in Georgia charges $2,500 for a retractable foreskin and $3,000 for a non-retractable foreskin.
- Circumcision is usually performed on infants within two weeks of birth. A numbing lotion is usually applied to the penis at least half an hour before the surgery. The doctor next cleans the penis before injecting a local anesthetic around the base. A special clamp is usually placed on the penis to allow the doctor to draw the excess foreskin up and remove it with a knife or scissors. Alternatively, a disposable plastic device can be placed on the end of the penis and secured with a string; the excess foreskin and device will fall off after about a week. The treatment usually takes between 10 and 30 minutes. It takes roughly ten days for the wound to heal.
- Circumcision may be performed on an older child or adult for cosmetic, social, or medical reasons, such as a tight foreskin, inability to retract the foreskin, or recurrent infections. Local or general anesthesia can be utilized in these situations. In most cases, the patient will need to take at least three days off work, and full recuperation will take around a month.
- Many doctors and hospitals provide discounts to individuals who pay cash or who pay on time.
- According to the American Academy of Pediatrics, the prospective medical benefits of regular circumcision for newborns are insufficient to support its recommendation.
How much does a teenage circumcision cost?
Cost is a common obstacle to adult MC, according to acceptability studies, while willingness is stronger if costs are paid by others. The cost barrier, particularly for low-income families, has been exacerbated by an unscientific (but effective) lobbying campaign by MC opponents, which resulted in Medicaid coverage for circumcision being eliminated in 18 states in the United States (roughly one out of every six Americans as of June 2010), and a ban on elective MC in public hospitals in all but one state in Australia. While the short-term expenses to the health-care system may have been lowered, the long-term costs of medical need and conditions created by circumcision can only be higher.
A newborn circumcision is much less expensive than circumcision later in life. Circumcision in infancy costs between $165 to $257 in the United States, compared to approximately US$1,800-2,000 in adolescence or maturity. Even if an adolescent or adult male desires circumcision, the cost may be exorbitant. Because the expenses of a general anesthesiologist might be quite high, insisting on a local anesthetic can save money. Circumcision is approximately US$59 for adults or adolescents and US$15 for babies in underdeveloped nations.
Although the costs in industrialized countries are higher, when expressed as a percentage of GDP per capita, the figures are comparable: Neonatal MC costs 0.4 percent to 1.4 percent of GDP per capita, while MC in adolescents or adults costs 4.2 percent to 5.4 percent. At a cost-effectiveness criterion of less than 1% of GDP per capita, health interventions are deemed extremely cost-effective. As a result, the expense of adult MC is substantial. The lower salaries common of younger males do not aid MC affordability. The tremendous poverty of many individuals in developing countries means that the majority of the population cannot afford anything.
While MC protects against a variety of diseases and infections, in the case of HIV, boosting adult MC should be considered an urgent goal in areas where HIV prevalence is high and MC rates are low, while raising newborn MC should be a priority. Infant MC should be prioritized in populations where HIV infection is still low and MC rates are low.
How much does a circumcision cost for a 25 year old?
Circumcision will cost approximately Rs. 30,000 in India. If you utilize Credihealth, the price might be reduced to Rs. 15,800. Credihealth gives you instant access to all of the information you need in one place. You can compare the costs of surgery at several institutions and choose a doctor who you believe is the best fit for you. With a few mouse clicks, you can access all of this information. Credihealth can also help with scheduling appointments and online consultations. You can get your post-surgery medications without ever leaving the comfort of your own home.
Does Medi cal cover circumcision 2021?
Clinical Coverage Policy 1A-22, Medically Necessary Circumcision, has been revised with grammar and punctuation updates and posted on the Physician Clinical Coverage Policies page of the NC Medicaid website with an effective date of May 15, 2021, due to confusion with the language in the Jan. 1, 2021, posting.
NC Circumcisions that are medically required are covered by Medicaid, according to policy (and legislation). The coverage covers medical need for both the newborn and non-newborn age groups covered by CPT. NC Medicaid added preventive wording to the policy, however the family requesting the circumcision and the physician are responsible for determining medical necessity (including for HIV prevention).
Medical need for neonatal circumcisions has been updated to include any of the following as of Jan. 1, 2021:
Medical need for non-newborn circumcisions has been updated to encompass any of the following as of Jan. 1, 2021:
- For a beneficiary aged six and up, true phimosis producing urinary blockage, hematuria, or preputial discomfort
- Secondary or acquired phimosis that results in urinary blockage, hematuria, or preputial discomfort that does not respond to medical treatment
Providers billing for medically necessary circumcisions performed for disease prevention for newborn and non-newborn male beneficiaries should submit diagnosis Z29.8 (encounter of other specified preventive measures) and an appropriate circumcision procedure code beginning January 1, 2021.
For further general wording and formatting adjustments, providers should examine Clinical Policy 1A-22, Medically Necessary Circumcision on the Physician Clinical Coverage Policies portion of the NC Medicaid website.