Vasectomy: Is it Covered Under Medicare?

Unfortunately, vasectomies won’t be covered under your Original Medicare (part A and part B) plan. There are some Medicare Advantage coverages which might be able to pay for vasectomies, however, it is not obligatory for an insurance provider to cover them. In case you are already enrolled in MA plan, you must get in touch with your policy provider in order to see whether your selected coverage will be able to pay for vasectomy. However, more often than not, the procedure might not be covered by your current plan.


Despite the fact that Medicare Part A and Part B doesn’t cover vasectomy or similar birth control procedures, your doctor might advice you a reasonable option for avoiding pregnancy. In addition, you might also find an alternative health coverage if covering vasectomy costs by yourself is not an option for you.


Sterilization & Medicare:


Under Medicare, any sort of sterilization will only be covered when it’s essential for treating an injury or illness.

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If the sterilization is elective, like the one in case of a hysterectomy, tubal ligation, or vasectomy where it is the basic purpose, it won’t be covered by your Original Medicare Policy.


Even though the benefits of Part A as well as Part B Medicare can be received through a Medicare Advantage Plan, you must remember that the Advantage Plan is run by private insurance agencies and not by the government. The Medicare Advantage plan in addition to these benefits also offer some additional benefits which aren’t covered by your Original Medicare Plan. Hence, there is a possibility that you might see the sterilization procedure as one of the additional benefits under your Medicare Advantage plan. Nonetheless, it is always best to contact your insurance company prior to scheduling your appointment.


Does Medicare Supplement Plans Cover Vasectomy?


Medigap otherwise known as Supplemental Plans won’t cover your vasectomy either. These plans are intended to help seniors above the age of 65 to cover some of their out of the pocket expenses related to their Original Medicare Coverage. More often than not, these will be typically in the form of co-payments, coinsurance & deductibles. Contact your Medigap policy provider to get more info that is specific to your requirements.


To sum up, you can get your Vasectomy costs covered by some Medicare Advantage Plans, however, do not expect that they will be covered by your Original Medicare or Medigap policy. You can also contact an experienced and reputed Medicare consultant and let them know your exact requirements to get the best coverage within your given budget.