In the past, many health insurance policies have provided coverage for vasectomy, a medical procedure used as a permanent form of male contraception. By contrast, similar female contraceptive procedures (such as tubal ligation) were not traditionally covered, or were only partially covered by health insurance.
The pendulum has swung the other way under Obamacare, or the Affordable Care Act (ACA), with women’s health and wellness receiving additional coverage to a degree. Now women are granted certain contraceptive options as part of their coverage.
Covered contraception for women includes hormonal methods (birth control pills, vaginal rings), IUDs, barrier methods (diaphragms, sponges), emergency methods (Plan B), and even sterilization procedures. Also included are patient education and counseling services related to contraception.
Unfortunately, Obamacare does not cover vasectomy, or any form of male birth control (such as condoms).
Will Obamacare Cover Vasectomy?
At the moment, there is no plan to include vasectomy or any other form of male contraception as part of the covered care provided for under Obamacare. However, it is possible that health insurance providers could add it to their covered preventive services on their own.
Vasectomies are less invasive and less expensive than corresponding female sterilization procedures like tubal ligation. For couples seeking a permanent means of contraception, vasectomy is generally preferable to tubal ligation for a few important reasons.
First and foremost, it is more reliable. With a vasectomy, tests (to check sperm count) can be conducted following the procedure to ensure that the surgery was effective. With tubal ligation, the only way to know for sure that it worked is if it didn’t (i.e. subsequent pregnancy).
In addition, tubal ligation is a far more intrusive surgical procedure, requiring at least several hours in the hospital following the procedure if everything goes well. Vasectomy, on the other hand, is a non-invasive, out-patient procedure that typically takes less than an hour, after which the patient is allowed to go home. Recovery time for vasectomy is also less than for tubal ligation.
For insurance providers that are required to cover the cost of sterilization procedures for women, encouraging male partners to undergo a far less expensive (and less invasive) procedure would seem to be preferable. However, since vasectomy is not required under Obamacare, it is not yet covered.
Other Insurance Options
Private insurance providers may offer coverage for any number of services not required under Obamacare, so long as they meet standards for essential minimum coverage. You may therefore want to explore all of your options, including both plans offered through state health exchanges and third-party policies offered privately. Many private insurance providers continue to offer coverage for vasectomy.
Alternative Methods of Contraception
Unfortunately, you will not receive coverage for a vasectomy if a policy under Obamacare is your best option because it is provided through your work, it offers the cost-assistance you need, or due to other circumstances. However, this doesn’t necessarily mean you have to forego the safe sex and family planning offered by contraceptives.
Planned Parenthood not only provides free male contraceptives to patients (condoms), but they also perform vasectomies. While you can certainly visit a urologist or even some general practitioners to have the procedure performed, the advantage of going to Planned Parenthood is that they offer patients a sliding fee scale. For those with limited income, this may be the best option.