Bottom line, for most men a vasectomy reversal is usually not covered by most insurance plans. Insurance companies think it is an elective and so not a “medically necessary” procedure. They do not want to pay for correcting a past decision that men now regret. Plus, I have been told by an insurance insider that a successful vasectomy reversal will increase insurance company costs as they now have to pay for the delivery and costs for more children with no additional income to cover these expenses.

Because there are many thousands of insurance plans and so many variations within each plan, each patient will have to call the insurance company and find out if the specific plan that they have will cover an “outpatient microsurgical vasovasostomy” (code # 55400-50). It is best not to say the words “vasectomy reversal.” See our affordable payment options available!

ICVR is not contracted with any insurance company, business or government/military entity or veterans agency. We simply cannot hire several more full-time employees just to file and re-file hundreds of claims over and over again with months of challenges and battles with insurance companies all over the US and around the world. Instead, we have found that is is easier for the patient pay for the vas reversal up front and then apply to the insurance company for reimbursement. We provide a copy of the operative note to help with this process.

Plus, because we know that a well performed microsurgical reverse vasectomy is not cheap, we offer payment options for most couples.

Even if the insurance company representative says that “yes, an outpatient vas reversal is covered,” as they often do, please know that what the representative says usually is not true and they will refuse to pay later on. It’s one of those fine print things buried deep in the health insurance contract that no one ever reads. When they say “yes, it is covered” what they really are saying is that under the terms of the insurance contract, outpatient surgery even with a non-contracted provider is usually a “covered expense.”

Even if the insurance company or agency does “approve” the vas reversal and actually sends a check to the doctor, in my experience it may be only a few hundred dollars for a several thousand-dollar procedure. They reason is that the insurance company alone gets to decide how much they think is “reasonable and customary” for a vasectomy reversal in 2024, even though it is many thousands less than the true costs. Some insurance plans try to direct patients to an “in plan” contracted urologist to do the vas reversal, even if the doctor is not trained, skilled or experienced in urologic microsurgery.

Even if the insurance company representative says that “yes, an outpatient vas reversal is covered,” as they often do, please know that what the representative says usually is not true and they will refuse to pay later on. It’s one of those fine print things buried deep in the health insurance contract that no one ever reads. When they say “yes, it is covered” what they really are saying is that under the terms of the insurance contract, outpatient surgery even with a non-contracted provider is usually a “covered expense.”

The problem is that in the decades of our performing many thousands and thousands of vasectomy reversals, the insurance company almost always will deny payment later on after the surgery. Here’s how they can do that – the authorization department that says that it is “covered” is not the same department that later on has to approve the payment and write the check. The payment division then explains that even if “pre-approved,” the insurance company is not legally bound to pay. This then leaves the patient now responsible to pay the unexpected bill.

We know that many couples do not qualify and so we offer a personalized, customized in-house, no-interest payment arrangement. We work with various financial institutions with programs to loan each patient the money for all or part of the vas reversal costs. We can suggest a few that we have worked with over many years that provide the best service. Learn more about our payment options here!