Dad in yellow shirt carrying two kids in a field of flowers with a tree and another kid walking in front

Is a Vasectomy Covered By Insurance? It Depends So See How To Find Out

Well it’s come down to it. You have decided that more children (or none at all) is not something you are going to pursue. After my third child – who was a surprise – my wife and I decided that we were done having kids. When you find yourself in a similar situation you will probably be looking at your health insurance plan. But is a vasectomy covered by insurance?

booklet used to keep track of insurance payments and doctors appointments

Like all medical procedures there are a lot of things you will need to check on to determine if your medical insurance company will help pay for a vasectomy. The good news is that it is not difficult to find out how your insurance company handles getting snipped.

What Is A Vasectomy?

Put simply, a vasectomy is male sterilization. It is a surgical procedure in which a doctor cuts or blocks the vas deferens, which are tubes that carry sperm to the rest of the body to be mixed with fluids that create semen.

After a vasectomy your body will still produce semen, it just will not contain sperm, meaning you cannot get someone pregnant. The sperm that is blocked by the vasectomy end up getting absorbed by the body.

Surgical instruments scissors and scalpel laid on on a table prepared for a vasectomy procedure

After your vasectomy, you will be asked by your doctor to ejaculate a lot to make sure you get rid of all of the extra sperm that could get into your semen. This can be done through sex or ejaculation. Once you have done that you will have to give a semen sample to a lab to check to see if the vasectomy is effective.

It is important to note that a vasectomy is not 100% effective. It is possible for the vas deferens to reconnect so that sperm can mix with semen once again. I had to sign several waivers noting that I understood the risk.

Is A Vasectomy Painful?

The actual vasectomy procedure is not painful if done correctly. When my doctor started cutting he asked what my pain was on a scale of 1 to 10. When I said a 2 he said that was good because if the local anesthesia wasn’t working then I would have been at a 10.

That being said, the days after the vasectomy surgery were very painful for me. It was hard to walk, and just sitting in a chair was painful. My balls were killing me.

sewing ball with pens in it is what testicles feel like after a vasectomy

My doctor gave me a small prescription of pain killers. I ended up having to ask for a refill, which got me to the end of the pain period. In all, it was about 3 weeks before I felt no pain at all.

Bottom line…if your doctor tells you you’ll feel better in a week, don’t believe him.

Are You Awake For A Vasectomy?

This was one of my first questions. I wanted to know if I’d be awake for my vasectomy. The answer was yes, I was wide awake. The anesthesia was a local anesthesia, so I was able to actually talk to the doctor while the procedure was taking place.

I liked being awake for the vasectomy, because there was no recovery time and it didn’t take as long to get in and get out of the doctor’s office.

The vasectomy only took about 15 minutes once the doctor got started, so I was in and out in on time.

What Is The Average Cost Of A Vasectomy?

The cost of a vasectomy depends on if you have insurance. Without insurance, the cost of the procedure is around $1,000.

With insurance, the cost is a few hundred dollars less. A look at my Blue Cross Blue Shield online portal shows that the procedure costs anywhere between $453 – $906 in my area, depending on which provider performs the surgery.

Piggy bank with two black eyes. It takes more than a piggy bank to pay for a vasectomy

The cost an individual member would pay would depend on the plan design of their health insurance plan. We’ll get into that more down below.

But first, you need to determine if a vasectomy is covered by your insurance plan.

Is A Vasectomy Covered By Insurance Plans Available To Me?

Most insurance plans cover vasectomies. They are routine procedures, and they are preventive in nature, meaning that while an insurance plan will spend a few hundred dollars, the procedure will most likely keep other more claims, i.e. pregnancy, from ever occurring.

But to find out for sure if a vasectomy is covered by your medical insurance plan, do these 3 things.

Check Your Plan Summary

All insurance plans come with a detailed plan summary. If you have a plan through your employer, you can ask for the Summary Plan Description, or SPD. This may have information on vasectomy coverage.

man sitting at a table counting money while asking is a vasectomy covered by insurance

Call The Insurance Company

I work as a health insurance consultant. I sometimes get calls from clients about coverage for individual procedures. While I am always happy to help, I also advise the customer that they will get a more complete answer if they call the insurance company directly.

The number to your insurance company is on the back of your ID card, and while many people don’t like to use the phone, it’s still the best way to find out how your insurance plans work.

When you talk to the insurance company directly, you will be talking to someone that has all of your information and all of your plan’s information right in front of their eyes. Plus, that person will be able to tell you where you stand with your deductible and out of pocket maximum, so you will know how much you will have to pay for the vasectomy.

Talk To Your Human Resources Department

If your health insurance plan is through your employer or your spouse’s employer, they can also help find out if a vasectomy is covered by your health insurance plan.

I would still try to go straight to the insurance company first, but you can also get help by contacting your Benefits Manager. If he or she doesn’t know offhand if you’ll have coverage, then they will know the right people to ask.

The Benefits Manager had a hand in designing the benefit plan, so they will definitely be able to get you an answer.

What Will A Vasectomy Cost You If You Have Insurance?

Up above I discussed the average overall cost of a vasectomy. But if you have health insurance you may not have to pay that entire cost. It all depends on what your plan design calls for.

The best way to get an idea of how much the sterilization procedure will come out of your own pocket, you can take a look at your plan’s Summary of Benefits and Coverage, or SBC. An SBC is a requirement of the Affordable Care Act, and it clearly outlines your deductible, coinsurance, copays, and other aspects of your plan.

dollar bills spread out on a table

When it comes to deductibles, if you are covering your family on your plan you will need to know if your deductible is an embedded or aggregate deductible. An embedded deductible will be more beneficial to you, and it could be the difference between paying for the entire cost of a vasectomy or just part of it.

You will also want to pay attention to your out-of-pocket maximum. Once you and/or your family have reached the out-of-pocket maximum you will no longer be required to pay anything for a network medical or pharmacy service. Some people plan out a vasectomy and other surgeries during years where they have already reached their out-of-pocket maximum.

In fact, many times a vasectomy can be done without any out-of-pocket costs. How? Well, many times men get vasectomies after the birth of a child, and the mother and baby might have enough claims to get a family to the out-of-pocket maximum. If this happens, and you get a vasectomy in the same plan year, you won’t have to pay anything as long as the procedure is performed by a doctor in your network.

How To Find An Insurance Plan That Covers Vasectomies

If you need to find a health insurance plan that covers vasectomies, the best way to find one is through an online marketplace or exchange. When you do this you will be able to compare multiple plans for the benefits and price that are right for you.

The marketplace I recommend is eHealthInsurance. They are able to quickly get you the best rates side-by-side so you can make the best decision for your family.

Finishing up

Getting a vasectomy is a big decision. There is enough to worry about without having to stress over how to pay for it.

Follow the steps above, and you can be sure that you will know exactly how a vasectomy will impact you financially.

 

 

Read More

Will My Health Insurance Cover A Tummy Tuck Surgery

“Will my insurance cover a tummy tuck surgery” is something that many people have wondered. After all, there are many reasons to need a abdominoplasty, with the two most popular times for people to get a tummy tuck being after pregnancy and after major weight loss.

But tummy tuck procedures are expensive. An average cost is $5,500, but they can easily be over $10,000 if a more involved surgery is required. That is a lot of money to shell out. Money that most people do not have laying around. That leads many people to ask if their insurance plan will pay for the tummy tuck.


Will Insurance Cover A Tummy Tuck Surgery?

A tummy tuck is usually classified as an elective, cosmetic procedure. It probably doesn’t feel that way when you need one, especially if the reason is that you had a baby or lost a lot of weight. However, many insurance companies feel that you can live without the procedure, so they do not want to pay for it.

But that doesn’t mean you should just take no for an answer and not even inquire about it. Each individual health insurance plan is different. Make sure to call your insurance company to find out if they will cover a tummy tuck. If your doctor classifies the abdominoplasty as medically necessary then you might have a fighting chance at getting some help paying the bill.

What To Do If A Tummy Tuck Is Covered By Insurance

If you are one of the lucky ones that can get the tummy tuck procedure covered by insurance, then there are a couple of things you will want to be aware of.

First, make sure you have the surgery performed at an in-network facility. You will save a ton of money by going in-network. The problem with many cosmetic surgeries is that many physicians are not in-network. Still look around, though, and ask your insurance company or look on their website for network-contracted doctors that can perform the tummy tuck.

Second, make sure you have a clear understanding of what you will owe for the procedure, and get it in writing. Even if you have an insurance plan that will cover the tummy tuck, you will still be out quite a bit of money if you haven’t hit your deductible and/or out-of-pocket maximum. Don’t get surprised later on just because you didn’t do enough research at the beginning.

How To Pay For A Tummy Tuck When Insurance Won’t Pay

If you are like most of us, and you have an insurance plan that won’t pay for a tummy tuck, then how best to pay the big bill? First off, make sure you really want a tummy tuck. Before you pay upwards of $10,000, make sure it is something you really want to do. If you have buyer’s remorse on a car, you can take the car back or sell it to someone else. However, if you have buyer’s remorse on a surgery, there’s nothing you can do.

Second, check with the doctor’s office about payment plans they may have. They know that most people can’t afford to hand over thousands of dollars at one time, and many will work with you to pay your bill. It means going into debt, so again, make sure you are truly ready to have a tummy tuck.

And above all, make sure you do your research to find the right medical provider for you. Look for both cost and ability, and make the best decision for you or your family.

So, will your health insurance company cover a tummy tuck surgery? That depends on your plan and your medical necessity. Call your insurance company, check out their website, and talk to your doctor. You will then have all the information you need to make the best decision for you and your family.


Read More

Where To Find The Best Cheap Discount Dental Plans And Quotes Near Me

Are you looking for cheap dental insurance and discount dental plans near you? Maybe you are needing dental implants, orthodontic insurance, or simply a cleaning.  Perhaps you need dental insurance for kids or dental insurance for seniors. No matter what you are needing, you are probably wanting your purchase to be cheap insurance for affordable dental care. Before you read any further, you will want to check out great discount dental plans and quotes near you by clicking on the link below.

Join today and get 10% off any plan and 1-Month free! Just use code CJ10

Why Buy Discount Dental Plans?

No dental insurance? Before you buy dental coverage and go looking for a dental clinic near you, it would be good to understand why you might need to look into discount dental plans. Many people think the cost of a cleaning is low cost dental work, so why not just find a cheap dentist without insurance, pay out of pocket, and not pay premiums for full coverage dental insurance? That’s not a bad way to think, but consider these other dental costs that will be a heavy burden, especially for those needing low income dental care.

  • Braces – Most kids will need braces, and many adults need them too. The average cost of braces is between $3,000-$7,500. Now, even with dental insurance for braces, you will pay some out of pocket since most plans limit the coverage. However, with a good dental plan you can get a discount on the price of the braces and save a ton of money vs. what you would pay without orthodontic insurance.
  • Dental Implants – Dental implants, also known as root canals, have an average cost of $4,000. Can you imagine the physical pain of a root canal being compounded by a $4,000 dentist bill? Dental insurance companies offer dental implant insurance that greatly reduces your expenses.

The dentist prices associated with braces and dental implants are just a couple of high cost expenses that can occur. When you find the best dental insurance plan and best discount dental plan near you, you can mitigate these costs and get affordable dental care.

Save Up to 60% on Dental Care. Join. Save. Smile.

What Kind of Dental Plans Are Available Near Me?

There are a number of different types of cheap dental plans near you.

  • Do you want insurance just for yourself or your family? Individual dental insurance plans and family dental insurance plans can be purchased, depending on your needs. Compare dental plan prices in your area and see the dental plan quotes for all your dental needs.
  • Dental Discount Plans – Want a dental plan without a waiting period? Then you need to get a discount dental plan.  Discount dental plans can be a great way to find affordable dental plans to get low cost dental care. Please note that dental discount plans are NOT full coverage dental insurance. They are simply a discount on the cost of dental services. However, a dental discount card can be very valuable and allow you to find an affordable way to get cheap dental care. They are much cheaper than dental insurance. Find great plans here!
  • PPO Dental Insurance – Dental insurance PPO plans are what many people are familiar with. There is usually a deductible and annual maximum, and you pay a percentage, or coinsurance, for services. Many times a cleaning is paid for at 100%, allowing you to get free dental work!
  • HMO Dental Insurance – A dental insurance HMO plan is similar to a PPO dental insurance plan. However, HMO plans usually have a set fee for each service that a dentist might perform.

Save 10-60% and Get 1-Month FREE! with :DentalPlans

Who Should Buy A Discount Dental Plan

Discount dental plans are great for anyone who wants to get cheap dental work but not pay a lot for that privilege. Dental discount plans give you freedom to find a cheap dentist and get even more bang for your buck. No worries about networks.

College students are great for discount dental plans. When your child is away from home, you want to know that they will be taken care of if they had to go see a dentist. Discount dental plans are great, inexpensive dental plans for college students. Here is a great offer for college students:

college students dental insurance discount dental plan where to find a dental plan near me
Great dental plan offer for college students.

 

How To Get Discount Dental Plans, And How Much Are Discount Dental Plans Near Me?

Fortunately, it is easy to find out how to get discount dental plans near you, and how much a discount dental plan is near you. You can go here to compare dental plans and find the dental insurance cost that you are comfortable with. Once you get your plan, you can start looking for a dentist that can provide you with the cheap dental work that you need to get that beautiful smile.

Visit :DentalPlans to choose from 40+ affordable dental savings plans. Join today and receive 1 additional month of membership free! Use promo code 1FREE

Read More

Iphones and Tables and ipads

Telemedicine Benefits and Disadvantages for Patient Primary Care

As the cost of health care premiums increase and out-of-pocket limits in health insurance plans continue to rise, people are left to wonder what can be done about the rising cost of health care. People with High Deductible Health Plans and HSAs are especially hard hit when it comes to the simplest parts of receiving health care. An HSA member can find that a routine visit to a primary care physician is at least $100. Many times, much more than that.

One of the ways to combat this charge is to enroll in telemedicine, such as Teladoc or DoctorNowPlease. With telemedicine you can have a doctor consultation over the phone. Sometimes this is done on a voice call, and sometimes this is done through a face-to-face interaction through a smartphone.

Telehealth is a terrific way to lower the cost of medical services while still receiving quality care. Here are some telemedicine benefits and disadvantages for patient primary care.



 

Telemedicine Benefits

Lower Cost for a Physician Consultation

The typical cost for a doctor visit varies based on the member’s plan design, but even the most generous copays today are $15 per visit. Usually the cost is much more, especially if you are on a bronze plan from the Marketplace.

As mentioned above, telemedicine is a great way to lower the cost of HSA out-of-pocket expenses, as an HSA plan could cost you $100-200 just to see a doctor about a sinus infection. That’s ridiculous.

If you buy a telemedicine program, the cost to see the doctor is much lower. When all you need is for someone to hear your symptoms and give you a simple antibiotic, do you really want to spend a small fortune? Of course not. The best telemedicine benefit is that the charge to have a doctor see you is lower than what you would pay to see him or her in person.

Less Time Spent Away From Other Things

In addition to too much cash out of your pocket when going to a doctor’s office, a trip to the doctor takes valuable time out of your day. How many of us have employers that will allow us to take half a day off to go see a doctor for something minor? That leaves us either taking vacation or going after-hours to an urgent care or emergency room, where the cost to be seen skyrockets.

With telemedicine, you can have a conversation by a doctor in a matter of minutes right from your home, office, car, wherever. And then you can go pick up your prescription at your convenience. Instead of 4 hours away from work, you can get by with just 15 minutes away from work.

Open on Weekends

What do you do if you get a sinus infection on a Saturday and your doctor is closed? Your choices are:

  • Go to an urgent care center (expensive and time consuming)
  • Go to the emergency room (more expensive and more time consuming)
  • Tough it out until Monday (suffer in pain and take off work on Monday)

An even better question is what do you do if your kids get sick on the weekend? Can kids use telemedicine? Of course they can. Another great telemedicine benefit is that you can call them on the weekend. A doctor will always be available. You can start taking a prescription on Saturday and be ready to go by Monday.

Telemedicine Docs Can Call in Prescriptions

Most doctors offices nowadays will call in a prescription for you during your visit. Telemedicine is no different. After your talk with the physician, he or she will send a message to your pharmacy to have your prescription ready. You can simply pick it up after school, after work, or any other time that is convenient for you.

Don’t think that just because you did not go to their offices that the doctors can’t get you taken care of as soon as possible.

Can Be Done Over the Phone or Face-to-Face

When telemedicine burst onto the scene, all of the consultations were phone conversations. Today, many of these companies offer both voice and video conferencing. The doctor can look you in the eye and tell if there is something wrong with you. Maybe not as good as a real doctor could see you, but any additional information that the teladoc can have, the better.

The Doctors Take More Time With You

My experience with telemedicine is that the doctors make a great effort to completely understand my situation. While primary care physicians are great at their jobs, they are overbooked. When you have a minor illness you are lucky to get 5 minutes of time with your doctor.

With telemedicine, you can have a good conversation with the doctor and feel comfortable that they are diagnosing you correctly. At least in my opinion and experience.


Telemedicine Disadvantages

Can’t Fix “Big Stuff”

Telemedicine is for issues that can be diagnosed and treated quickly and easily. If you suspect something larger, a telemedicine doctor is not for you. You need to see your primary care physician, specialist, or emergency room. Telemedicine is also not a replacement for a relationship with a primary care physician. While telemedicine is great for one-time issues, if there are recurring problems, a primary care physician should be consulted.

Can’t Dispense Narcotics

This goes with the above paragraph. Most states will not allow a telemedicine provider to write a prescription for a narcotic. So if you have something come up that needs the strong stuff, telemedicine will not be able to help you. But they may still charge you for the call. Go see your family doctor.

Won’t Count Toward Out-of-Pocket Expenses

With Obamacare, there are annual limits on the amount of out-of-pocket expenses that individuals can spend on any health insurance plan. If you have a medical service or get a prescription filled with your health plan, your out-of-pocket expenses count toward this limit.

Unless your telehealth program is through your health insurance plan, and some are, your telemedicine cost will not be counted toward the out-of-pocket maximum. Since a telemedicine consultation is not a huge expense it may not matter, but it is something to keep in mind.

Not Available in All States

Lastly, telemedicine is available in almost all states, but not every one of them. And some that do allow telemedicine only allow it through face-to-face smartphone calls. So if you are interested, check out the states that your potential plan operates in.

Telemedicine Benefits Outweigh the Disadvantages

The cost of telemedicine is low, and you save time by enrolling in a telemedicine plan. Why not take advantage? Usually all it takes is about 2 calls to make it financially worthwhile. If you have a family, you could go to the doctor twice by the time January is over each year. So take a look at telemedicine benefits and disadvantages and see if it is something that you want to participate in.

Read More

Stethoscope and a calulator. Calculators are sometimes needed to determine an embedded deductible for health insurance

Best Ways To Get Health Insurance Between Jobs




Changing jobs is a hassle. Even when the change is your decision and you are excited about making a move, there is a lot of uneasiness that comes with finding new work. When you are between jobs due to a termination of some sort, it is not uneasiness you deal with, it is piles of stress. One of the biggest issues during a change of employment is finding good health insurance between jobs.

Fortunately, there are a few ways to make sure that you and your family are covered in the event you find yourself without employer sponsored health insurance.

Before you start looking at your options, there are a couple of things you will need to understand.

  • First, make sure you have a firm understanding of when your coverage will begin at the new place. The Patient Protection and Affordable Care Act (PPACA) limits, for the most part, waiting periods to less than 90 days. Still, you will need to know if you will be covered on your new date of hire, first of the month following date of hire, first of the month following 60 days of employment, etc.
  • Second, know going in that some of these options will be more costly than what you were paying at the old place. Your employer was most likely subsidizing a large portion of your premium. The amount varies by the employer, and some do not pay much, but some do.
  • Third, a new plan will most likely have a different provider network, meaning your old doctor may not be in the network and you will pay more to visit him/her. Or you may not be able to visit that person at all. Check the networks of the plans you are considering.

Having said all that, here are the best ways you can get health insurance between jobs.




Health Insurance Marketplace

The health insurance marketplaces set up under PPACA are a great place to start when you find yourself looking for medical insurance at any point, especially if you are between jobs.

The marketplaces, also called exchanges, have an annual enrollment period during which everyone can enroll, but if you have certain qualifying events, you may enroll at any time during the year. A loss of coverage is considered a qualifying event, so if you lose your insurance coverage when you leave a former employer, you can purchase a plan on the marketplace.

On the marketplace you will be able to easily explore and compare insurance options available in your area. Marketplace plans can be more expensive than what you were paying at your job, but you might also be eligible for a subsidy to help pay the premium. If the price is right, the marketplace might be the best option for finding health insurance between jobs.

COBRA

Employers that employ 20 or more people are usually required to offer COBRA. COBRA allows employs to continue to be on their former employer’s health insurance plans. The catch is that the employee is required to pay the full cost of the premium plus a fee, usually an additional 2%. For a family plan, this can be upwards of $2,000 per month or even more. An individual plan might be around $500 per month, but compared to what the employee was most likely paying out of a paycheck, $500 is a big jump.

COBRA guarantees that your plan will stay the same, and your doctors will still be available. But it is costly, so make sure this is absolutely the best option for you when you need health insurance between jobs.

Short-Term Health Insurance

Another option is to get a short-term health insurance plan, or temporary health insurance. As the name implies, short-term health insurance is when you only will need the insurance for a small amount of time. It is not full coverage medical care, and it will not keep you from the PPACA individual mandate penalty. In fact, short-term health insurance is not subject to most of the PPACA provisions.

Companies offering short-term health insurance can deny coverage for pre-existing conditions, and they are not required to renew coverage.

Still, temporary insurance can be a great cost-effective way to get the medical care you need.

Want to know how to get a Short-Term Health Insurance Plan? We’ve got your covered! Check out your options and a great quote here.

Learn more about Short-Term Health Insurance here.

Coverage Through a Spouse’s Plan

For married couples, if both people work, the person that is between jobs can jump on their spouse’s plan if one is offered through that person’s employer.

There probably was a good reason why both people were not on the remaining plan to begin with, so there is a good chance that the coverage or price may not be as good as the coverage that was lost. But the plan may still be better and cheaper than what is available through the marketplace and COBRA. And the plan will definitely cover more than what short-term insurance covers.

If this option is available to you, it is probably your best bet when you need health insurance between jobs.

Want The Best Work-From-Home Job?

Learn How To Make Good Money From Your Own Computer

Make $$ Just By Typing Simple Words and Phrases

red button that says click here to find out how to get great work from home by thinking up slogans

Joining a Parent’s Plan

For people under age 26, enrolling in a parent’s employer-sponsored plan is a terrific option. Many employers do not charge much additional for children, and if another child is already on the plan, there is a good chance that the monthly cost will not increase at all. The plan still probably passes all the tests to avoid the mandate penalty, so it keeps you out of trouble with the IRS.

Health Insurance Between Jobs is Available

Being between employers is not always a fun thing to go through. Making sure you and your family are covered for medical expenses is a big priority. Fortunately, there are several ways to make sure everyone has quality and inexpensive health insurance between jobs.

Read More