A Spotlight on Vasectomy
While the Affordable Care Act requires most private health plans to provide coverage with no cost-sharing for a range of recommended preventive services, including female contraceptives and female sterilization, because male condoms and vasectomy procedures are considered to be services for men, they are not required to be covered under the law. Vasectomies, considered permanent sterilization methods for men, are typically out-patient procedures and can cost $1,000 or more without insurance. These procedures are generally much simpler and have fewer risks that tubal ligations which is the procedure that women who seek permanent contraception typically get. As part of the 2024 KFF Women’s Health Survey, a nationally representative sample of 1,191 men ages 18 to 64 were surveyed on a broad range of health issues. This data note highlights their responses to their experiences, knowledge, and perspectives about vasectomy services.
Just over one in ten men ages 18 to 64 (11%) say they have had a procedure that resulted in sterilization, such as a vasectomy (Figure 1). This rate is half of that reported by women, where 25% of those in the same age range report sterilization as their contraceptive method. Larger shares of older men say they have been sterilized compared to younger men, but 5% of men ages 18 to 25 report they have been sterilized. Over one in ten White men (13%) report having been sterilized compared to just 3% of Black men. Smaller shares of men with low incomes have had a sterilization procedure compared to men with higher incomes (7% vs.13%).
Among men who have not had a sterilization procedure, one in five (21%) say they would consider getting a vasectomy. The largest shares of men who would consider getting a vasectomy include men ages 26 to 35 (31%) and men ages 36 to 49 (25%), White men (25%), and men with higher incomes (24%).
Among men ages 18 to 64 who have considered getting a vasectomy but have not had one, reasons for not seeking the procedure included: worry about pain and/or complications from the procedure (39%), the cost of the procedure (31%), not having the time (23%), wanting the ability to have children in the future (21%), and relying on a different birth control method with their partner (20%) (Table 1). Among those who have never considered getting a vasectomy, six in ten (59%) say they do not need a vasectomy, or the question does not apply to them.
Regarding the perspectives about cost, most men aren’t sure whether insurance plans are required to pay the full cost of vasectomy procedures, which they are not required to cover. Plans may cover the procedure, but typically it is with cost-sharing, and the out-of-pocket costs are determined by plan coverage policy and deductibles. There are considerable gaps in understanding of coverage policy. A third (34%) of men ages 18 to 64 were aware that this was not a coverage requirement, but over half did not know (Figure 2).
There have been recent state-level policy changes to cover vasectomy procedures at no-cost similar to how sterilization procedures for women are required to be covered by federal law. As of June 2025, nine states require state-related health insurance plans to cover vasectomies at no cost to the patient: California, Illinois, Maryland, New Jersey, New Mexico, New York, Oregon, Vermont, and Washington. However, state-regulated benefit requirements do not apply to self-insured employer plans, which covered about two-thirds (63%) of covered workers in 2024.