Does Medicare Cover Circumcision?
- Does Medicare cover circumcision? Discover whether Medicare and Medicaid pay for medical and routine circumcision and how much the procedure costs out of pocket.
Circumcision is a common surgical procedure where the foreskin is removed from the end of the penis. Most circumcisions are performed in the first couple of weeks after birth, but children and adults can also be circumcised.
Around 60% of baby boys are circumcised in the United States, significantly higher than most other parts of the world. Most circumcisions are done for cultural or religious reasons, but the surgery is sometimes necessary to treat a medical problem.
How much does circumcision cost, and does Medicare cover circumcision? You can find out more about the procedure and how to fund it below.
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Does Medicare Cover Circumcision?
Medicare does not generally cover circumcision of infants, children or adults, and the procedure is not listed as covered on the Medicare website. It is also highly unlikely to be included in Medicare Advantage Plans, but some private health care insurers may pay for circumcision.
Medicare is designed to provide financial assistance to help cover the cost of treatment that is medically necessary. This means that the beneficiary must be experiencing a health condition that is causing symptoms to qualify. Although circumcision is common in the United States, most are not performed to correct a medical problem.
However, Medicare may cover medically necessary circumcision surgery. For example, some males develop a constricted foreskin, which can lead to localized swelling and pain and require circumcision to correct it. If your doctor believes there is a compelling medical reason to carry out circumcision, it may be worth asking if Medicare will cover it.
Does Medicaid Cover Circumcision?
Medicaid will cover circumcision for newborn and non-newborn males if a doctor says it is medically necessary and the affected person has an eligible condition. For example, Medicaid will consider funding beneficiaries if they have frequent urinary tract infections or a congenital abnormality that causes symptoms. Some states allow Medicaid funding for circumcisions for newborn males, even if there is no medical necessity.
Does Insurance Cover Circumcision?
Health insurance generally covers routine circumcisions, but it depends on your individual carrier and your plan. If the circumcision will alleviate a medical issue, such as the inability to retract foreskin, then may be more likely to cover the procedure. If there isn't an existing medical issue then circumcisions are generally considered elective procedures by insurance carriers, and generally isn't covered.
How Much Does Circumcision Cost?
Circumcising a newborn usually costs between $250 and $400. Older children and adults will generally have to pay between $800 and $3,000 or even more. Various factors affect the overall cost of circumcision surgery, including the reasons for surgery and the type of anesthetic used.
Is Circumcision Necessary?
Many people choose to have their male children circumcised or be circumcised themselves for cultural or religious reasons. There are some potential benefits to circumcision, even if the procedure isn't medically indicated, such as a slightly lower risk of sexually transmitted infections and penile cancer.
However, circumcision can occasionally lead to infection or bleeding, and the person may experience pain for a while after the procedure.
The American Academy of Pediatrics doesn't recommend circumcision without a medical reason. However, it states that parents should be allowed to decide for their children based on the potential benefits and drawbacks and their own culture and religion.
Does Circumcision Hurt?
Circumcision is usually performed in the hospital under a local anesthetic to relieve pain. A numbing cream is applied to the penis, and then, a local anesthetic is administered by injection once the cream has taken effect. The American Academy of Pediatrics doesn't recommend performing circumcision without an anesthetic. However, traditional methods, such as a sucrose pacifier, can be used to soothe the baby during the procedure alongside pharmacological pain relief.
It generally takes the penis around a week to heal after circumcision, and it may feel sore while it heals. Painkillers suitable for infants can help ease any discomfort after being circumcised.