Women’s Health

My husband would like to get a vasectomy but when I checked with our insurer, they told me that the plan would cover my sterilization without cost sharing but we would have to pay part of the costs for his procedure. What is the reason for that?

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Contraceptives, including sterilization, are covered only for women as preventive services by ACA-compliant plans. Since sterilization for men is not considered a preventive service under the Affordable Care Act, federal law does not require plans to cover vasectomies.  However, eight states (Illinois, Maryland, New Jersey, New Mexico, New York, Oregon, Vermont and Washington) require state regulated health insurance plans to cover vasectomies at no cost to the patient.  Check with your State Department of Insurance for more information.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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