Do any HMOs pay for a vasectomy?
Lee
I am in the midst of deciding on a health plan (USA) for next year, and was
wondering if any HMOs or PPOs cover part (or all) of the cost of a vasectomy.
According to the FAQ at www.v-i.com, many do, but neither of the two HMOs that
have insured me over the last four years would contribute even a small
percentage of the cost (even though one pitched in for oral contraceptives).
I have delayed getting my V for years now hoping it would be covered by my
next health plan.
I am having difficulty obtaining this information from HMO websites and the
thin pamphlets they hand out. My previous employer produced a comparison guide
for the health plans they offered that even showed which plans provide a co-pay
for a vasectomy *reversal* (only one did a few years back, and it's no longer
offered), but not a vasectomy itself. AARRGGHH! I'm sure I could ring all the
healthcare providers and find out (after spending much of the day on hold being
told how important my call is), but I figured somebody here may have already
done the legwork and can provide the lowdown on who covers what.
I've also called a few doctors and found the fees are quite a bit higher than
the "$200 to $500" quoted in the FAQ. Does this vary by region? And what is
the best way to go about choosing a doctor (assuming I have a choice, not
always the case with HMOs of course).
You guys in the UK don't know how good you have it!
Thanks,
Lee
John Q. Anonymous
Unlike your experience, the cost of my vasectomy did indeed fall into the
"$200 to $500" range, the insurance company did indeed cover it (more
correctly, they covered a substantial percentage after the deductible), and
the information about coverage was easily obtainable by calling the 800
number on the insurance card.
*shrug*
--
John Q. Anonymous
troutmas...@nospam.org
covers vasectomy 100%. But they only cost around $200, in any case, so
if they don't cover it, save some money, put it on a credit card, or
whatever... If you do pay for it out of pocket, make sure your doctor
doesn't have any "hidden costs" like taking biopsies, etc., which
could run a couple hundred dollars more. Make sure EVERY cost is
quoted to you!
James Clement
"Lee" <lrm...@hotmail.com> wrote in message
news:3B9861...@hotmail.com...
trifold
>
> I am in the midst of deciding on a health plan (USA) for next year, and was
> wondering if any HMOs or PPOs cover part (or all) of the cost of a vasectomy.
Kaiser Permanente covered my entire vasectomy: a prevas consult,
valium before, pre-emptive antibiotics afterwards, the procedure
itself, a post op checkup one week later, two in-office semen checks
involving more follow-up on healing etc.
Of course, since then, they have left the area! (But the doctors
stayed and have started their own group served by several insurance
outfits, and they also cover it.)
You may have to do this research yourself. Let us know what you find.
This would be good info. to spread around.
Lee
of the available health plans. Major healthcare providers have numerous plans
that go by similar names, it's easy to be confused.
I am leaning toward Blue Cross/Blue Shield (in Maryland), which is not an HMO
(although BCBS offers an HMO and a PPO as well). It will pay for the 80%
of the cost of the surgery and related procedures after I pay the deductible
(at least $100, depending on which plan I choose - larger deductibles mean
lower monthly payments). More importantly, it allows me to choose my own
doctor within the vast BCBS network, which most area doctors belong to. My
current plan doesn't cover "elective surgery" including vasectomies, and
my last two GPs have bolted from the plan leaving me to find a new internist
every 8 month or so.
The BCBS HMO plan would have an even lower deductible ($25 or less), but then
I would again be unable to see a specialist without a referral from the GP
which I've grown to find annoying, along with the other familiar HMO hassles.
-Lee
Keith Glavin
I'm new to this NG, but let me tell you...getting a vasectomy was by
far the biggest mistake of my life. I was in great health prior and
terrible health after. In my mind, there is a great correlation
between prostatitis, CPPS and a vasectomy. Anyone who says otherwise
isn't living through it like I am. Don't do it, it is not worth the
risk, even small, of getting what I have.
Steve Law
My sincere hopes that you find some way to recover. Some points:
[] Vasectomy 'ruined' a good part of my life. Reversal reversed some
of the problems. Total Testosterone is now much higher, PVP is abated
somewhat (enough that it does affect my activities, just still feel it
a bit)
[] Auto-immune problems are still understudied and can occur any time
post vasectomy.
[] Those that have not had any problems 'yet' propound too readily the
procedure.
[] Those that will not have any problems - God Bless Them - Ignorance
is bliss.
Those of us who have experienced the 'risks' and have done the
countless hours of quizzing doctors and spending time with more than
just short blurbs on the net or reading summaries produced by those
with an interest in the status quo, know the real risks.
To quote Proust: "The patient with the disease knows more than the
doctor due to his living with the disease and its consequences every
minute of his life."
Steve L
"Been There, Done That, Still Paying the Price"
P.S. David - 'interest in the status quo' does NOT mean 'grand
conspiracy'
trifold
<
> P.S. David - 'interest in the status quo' does NOT mean 'grand
> conspiracy'
If you review the literature on vasectomy, you will see that doctors
and scientists have gone looking for problems that could be related to
vasectomy. That is, they tried to find these problems. That is
because a doctor/scientist can become famous even by finding out bad
things. Science thrives on overturning apple carts. The fact is,
they didn't find anything even though they tried.
trifold
keith....@abbott.com (Keith Glavin) wrote in message news:
> I'm new to this NG, but let me tell you...getting a vasectomy was by
> far the biggest mistake of my life. I was in great health prior and
> terrible health after. In my mind, there is a great correlation
> between prostatitis, CPPS and a vasectomy. Anyone who says otherwise
> isn't living through it like I am. Don't do it, it is not worth the
> risk, even small, of getting what I have.
We haven't heard much about prostatitis at this newsgroup. You may be
interested in the recent study I found at Medline. It looks at a
fairly large group of aging men who experienced benign prostate
enlargment, concluding that vasectomy was not a risk factor. Of
course, benign prostate enlargement (BPH) is not the same thing as
prostatis, but the finding is interesting anyway. Prostatitis is a
condidition that seems to have multiple and varying symptoms, and no
one seems to know what causes it. Some even say it is not a single
condition. Do you know the newsgroup sci.med.prostate.prostatitis?
Some men there believe their prostatitis was brought on by vasectomy.
Others say they experienced their symptoms before vasectomy. And some
have never been vasectomised. The doctors who post there seem to
agree that the medical literature does not support a connection. But
I will do a Medline search on prostatitis and vasectomy to see what
comes up, and I will post whatever I find to the medical journals
section of the website.
Anyway, the abstract of the article on BPH is below:
*****
Journal of Clinical Epdemiology
We defined risk factors for a clinical diagnosis of benign prostatic
hyperplasia (BPH) among subjects of the
population-based Massachusetts Male Aging Study. In 1987-89 1709 men
aged 40-70 provided baseline risk factor
data and were followed for a mean of 9 years; 1019 men without
prostate cancer provided follow-up data. We
classified men
with clinical BPH at follow-up if they reported (1) frequent or
difficulty urinating and were told by a health
professional that they had an enlarged or swollen prostate or (2) if
they reported having surgery for BPH. At
follow-up the prevalence of clinical BPH was 19.4%, increasing from
8.4% of men aged 38-49 years to 33.5% of
men aged 60-70 years (P <
0.001 for trend). Elevated free PSA levels (age- and total
PSA-adjusted OR, top vs. bottom quartile ng/mL 4.4, 95%
CI
1.9-10.5), heart disease (age-adjusted OR 2.1, CI 1.3-3.3), and use of
beta-blocker medications (OR 1.8, CI
1.1-3.0)
increased odds for BPH, while current cigarette smoking (OR 0.5, CI
0.3-0.8) and high levels of physical activity (top
vs. bottom quartile kcals/day OR 0.5, CI 0.3-0.9) decreased odds of
BPH. All but the medication effects persisted in
fully adjusted multivariable models. Total or fat calorie intake,
sexual activity level, alcohol intake, body mass index,
waist-hip ratio, diastolic blood pressure, a history of diabetes,
hypertension, vasectomy, or serum levels of
androgens or estrogens did not individually predict clinical BPH. We
conclude that physical exercise and cigarette
smoking appear to protect against development of clinical BPH.
Elevated free PSA levels predict clinical BPH
independent of total PSA levels. Risk associated with heart disease
does not appear to be due solely to detection
bias or to effects of heart disease medications. A wide variety of
other characteristics appear to have no influence
on risk for clinical BPH.