Vasectomy Reversal Cost: Insurance, Financing

Vasectomy reversal costs can range from $5,000 to $20,000 depending upon the complexity of your surgery. There may be separate charges for the surgery, anesthesia, and the hospital or surgical center.

Most health insurance plans will not cover the cost of your vasectomy reversal or any the reversal of any elective sterilization, so it pays to plan ahead and utilize several key strategies:

• Affordable Surgery- vasectomy reversal costs are tax deductible
• Offset Risks - use supplemental insurance for the pending pregnancy
• Financing Options - an interest free loan that saves money
• Vasectomy Reversal or IVF? - if your medical plan covers In Vitro which costs more?

Many men undergo a vasectomy thinking they are done having children. But life can throw unexpected changes. Remarriage, loss of a child, and testicular pain are common reasons why men undergo a sterilization reversal surgery.

A urologist specializing in male infertility may perform the procedure. Microsurgical techniques are used to clear the way for sperm to travel from the testicles through the seminal tubes. There are two types of surgery that might be performed:

• Vasovasostomy - the surgeon sews back together the vas deferens
• Vasoepididymostomy - the vas deferens is attached directly to the back end of the testicles. This is a more involved procedure and may be higher in cost.

Because most health insurance plans do not provide coverage, you may need to pay the entire cost of vasectomy reversal upfront. The U.S. tax code provides two mechanisms to help you reduce your out-of-pocket expenses, and make your procedure more affordable:

• Unreimbursed medical deductions: out-of-pocket vasectomy reversal expenditures are tax deductible.  The IRS allows you to deduct unreimbursed medical expenses above 7.5% of your adjusted gross income (AGI).  Depending upon your payout and income, a substantial tax savings may be available to you.
• Flexible Spending Accounts: allow you to use pre-tax dollars for these same expenses, and provide two advantages over taking them as a deduction:
  • You save on both Federal income taxes and FICA taxes (7.65%).
  • You get first dollar tax savings.  

You can offset vasectomy reversal costs and risks by using supplemental insurance. Supplemental coverage can be leveraged to pay benefits that will pay back many of your out of pocket expenses. There are several risks associated with any surgery, and reversing a sterilization procedure has one other: mom may get pregnant, deliver a baby, and take an unpaid maternity leave.

Supplemental maternity insurance will cover mom's normal labor and delivery. It pays cash benefits directly to the insured. By timing the coverage start date with your surgery, mom's benefit for normal delivery may greatly exceed the premium you might pay. Use the surplus to repay your surgical costs. 

Your reversal surgery will entail certain risks. You may experience some side effects from your procedure. Most of these complications are minor and probably will not cause an extended disruption in income or hospitalization. Some of the issues that might arise after your procedure include:

• Bleeding within the scrotum - a collection of blood called a hematoma may form
• Sperm granuloma - sperm leaking into the scrotum may cause your immune system to overreact
• Hydrocele - fluid buildup around the testicle may cause painful swelling
• Post surgical infection - a risk with any surgery

Vasectomy reversal success rates are broken down into two categories:sperm return, and pregnancy rate. Time since the original vasectomy drives your odds of success. Sperm return rates varies from 70% to 90%, and the pregnancy rate from 30% to 76%. Consider the bigger picture when evaluating reversal success rates: what if it works and my wife gets pregnant, and what if it doesn't; what do we do then?

You wouldn't considering vasectomy reversal if you did not plan on having at least one child. Purchase supplemental maternity insurance before getting pregnant. By purchasing coverage for a planned event (successful vasectomy reversal, and your wife's pregnancy), the benefit paid to you can help you reimburse your surgical expenses. 

What it the surgery does not work? If your sperm does not return to normal function, the surgery may be declared unsuccessful. Surgeons will often charge far less to perform the surgery a second time. So factor this into the equation when considering the cost and benefit of undergoing surgery a second time for the same condition.

Sperm freezing (cryopreservation) is often recommended in case the procedure is not successful. Freezing your sperm gives you the option of choosing between repeating the surgery, or using ICSI - a procedure where your sperm is injected directly into your spouse’s eggs as part of IVF. ICSI combined with IVF is a far more expensive procedure - unless your insurance plan covers infertility. See more this topic below.

Patients often explore using Intracytoplasmic Sperm Injection (ICSI) in combination with In Vitro Fertilization (IVF) in case vasectomy reversal is unsuccessful. The surgery is tried first because costs are much lower, and the conception experience is more intimate and natural. Having a baby by IVF is very clinical. IVF and ICSI may be far more affordable than vasectomy reversal for some couples, and may make more sense as a first option for some.

The reason has to do with health insurance. Most plans won’t cover the reversal of sterilizations, but some are mandated to cover IVF. So which is cheaper, paying yourself for a less expensive reversal surgery, or having a 3rd party fund your costs for IVF?

Vasectomy reversal surgery expenses are usually not covered by health plans. They are viewed as elective procedures, and add to medical risks in two ways: the expense of the surgery, and the far bigger expense of resulting pregnancies. Carriers like keeping members infertile. Check your policy to see if the surgery is covered.

• Male infertility diagnosis code: 606.9
• Vasovasostomy procedure code: 55400

Fifteen states mandate infertility coverage by group health plans. Reversal of sterilizations is almost always specifically excluded by the mandates. Of that group nine specifically require coverage of IVF, and a subset includes benefits for ICSI. If the employer of one or both spouses is headquartered in one of these states, then vasectomy reversal may be the less affordable option, because the health plan is covering the IVF expenses.

The states which require payment for IVF are: Arkansas, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, New Jersey, Rhode Island, and Texas.