Does Medicare cover circumcision?
Medicare won't cover circumcision for infants or adults. However, Medicaid will provide coverage for infants. Adults who need circumcision will need to get approval from a private health insurance policy. Out-of-pocket circumcision costs $200 for an infant and $1,875 for males 12 and older. If you need help with circumcision costs, compare companies and shop around to find cheap health insurance rates.
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Kalyn Johnson
Insurance Claims Support & Sr. Adjuster
Kalyn grew up in an insurance family with a grandfather, aunt, and uncle leading successful careers as insurance agents. She soon found she has similar interests and followed in their footsteps. After spending about ten years working in the insurance industry as both an appraiser dispatcher and a senior property claims adjuster, she decided to combine her years of insurance experience with another...
Insurance Claims Support & Sr. Adjuster
UPDATED: Jul 6, 2023
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UPDATED: Jul 6, 2023
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- Medicare may not cover circumcision.
- It’s debatable whether circumcision will be covered for adults.
- Children without disabilities or kidney failure are not eligible for Medicare.
- Medicaid can provide help with circumcision costs for infants.
Medicare covers various treatments for its recipients, but does Medicare cover circumcision? Circumcision is a common surgery for infants and some teens, but it’s an uncommon surgery for adults.
Health insurance companies are known to cover circumcision, but there’s some uncertainty regarding Medicare insurance. Read through this short guide to learn about circumcision surgery and whether Medicare will cover it.
You probably can’t buy Medicare that covers circumcision, even an Advantage plan. But you can enter your ZIP code in our free online quote tool to find health insurance companies in your area that will cover circumcision. Finding the right health plan will help you reduce your health care costs.
Table of Contents
Does Medicare cover circumcision?
The short answer is no. Medicare doesn’t have a way to determine circumcision cost. You may see this listed as National Coverage Determine (NCD) or Local Coverage Determination (LCD).
This means that Medicare can’t determine the price through a national cost or state-level cost.
Does Medicaid cover circumcision?
Medicare can’t determine cost because circumcisions are usually taken care of by Medicaid insurance coverage. Low-income families can apply for Medicaid and get circumcision surgery for their infant son.
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How much does circumcision cost?
If you’re curious about the cost of circumcision, examine the data below.
| Age | Circumcision Costs |
|---|---|
| Male Child (Infant) | $200 - $400 |
| Male 12 years old and Older | $1,875 ($1,475 plus $400 to book an appointment) |
Compared to infants, circumcision for young boys and adult men could cost nearly $2,000. Although Medicare and Medicaid won’t cover circumcision for young boys and adult men, a health insurance company may.
Does Medicare cover surgery?
Medicare Part A and Part B cover surgeries only if the procedure is medically necessary to the patient’s health. Therefore, cosmetic and dental surgeries are not covered.
You’ll need to alert your Medicare about any surgeries. During this time, it may be a good idea to check your deductibles to see if you’re eligible to receive 100 percent help from Medicare.
Why may circumcision be beneficial?
According to the American Academy of Pediatrics, circumcision can prevent penile cancer, urinary tract infection and reduces the chance of transmitting a sexually transmitted infection (STI).
Circumcision Medicare Coverage: The Bottom Line
The best insurance companies will cover circumcision and other vital surgeries without much hassle. However, circumcision under Medicare is complicated.
Medicare doesn’t have a way to determine circumcision surgery, so it’s uncommon for the federally-funded program to cover the procedure. If the procedure is for an infant, your best bet is Medicaid.
Since affordable Medicare to cover circumcision isn’t an option, shop around. You can use our free comparison tool below to find an insurance company that will cover the surgery.
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Case Studies: Circumcision Coverage and Medicare
Case Study 1: John’s Circumcision Dilemma
John, a 30-year-old male, recently learned that he needs circumcision for medical reasons. As a Medicare recipient, he was uncertain if Medicare would cover the procedure. After thorough research, John discovered that Medicare does not typically cover circumcision for adult males. He reached out to his private health insurance policy and received approval for coverage.
Case Study 2: Sarah’s Infant Circumcision
Sarah and her husband recently welcomed a baby boy. They were interested in having him circumcised but were unsure if Medicare or Medicaid would cover the procedure. After consulting with their healthcare provider, they learned that Medicare does not cover infant circumcision. However, they found out that Medicaid provides coverage for such procedures for low-income families.
Case Study 3: Emily’s Search for Affordable Circumcision Coverage
Emily, a 25-year-old female, recently decided to undergo gender-affirming surgery, which included a circumcision procedure. As a Medicare recipient, she was unsure if Medicare would cover the cost of the surgery. After extensive research, Emily discovered that Medicare does not typically cover circumcision for adults, especially for gender-affirming purposes.
Frequently Asked Questions
Does Medicare cover circumcision?
Yes, Medicare may cover circumcision under certain circumstances. Medicare is a federal health insurance program in the United States that provides coverage for eligible individuals, primarily those who are 65 years old or older.
What is Medicare?
Medicare is a federal health insurance program in the United States that primarily provides coverage for individuals aged 65 and older, as well as certain younger individuals with disabilities or end-stage renal disease.
Under what circumstances does Medicare cover circumcision?
Medicare may cover circumcision if it is deemed medically necessary for the individual’s health. This typically includes cases where circumcision is required to treat a specific medical condition.
Are there any age restrictions for Medicare coverage of circumcision?
While Medicare generally covers individuals aged 65 and older, coverage for circumcision may be available to individuals of various age groups if it is medically necessary.
Are there any documentation requirements for Medicare coverage of circumcision?
Medicare may require specific documentation, such as medical records and a physician’s recommendation, to establish medical necessity for coverage of circumcision. Consult Medicare or your healthcare provider for detailed information.
Can I appeal if Medicare denies coverage for circumcision?
Yes, if Medicare denies coverage for circumcision, you have the right to appeal the decision. You can follow the established appeals process to request a reconsideration.
Are you looking for free insurance quotes?
Your one-stop online insurance guide. Get free quotes now!
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Kalyn Johnson
Insurance Claims Support & Sr. Adjuster
Kalyn grew up in an insurance family with a grandfather, aunt, and uncle leading successful careers as insurance agents. She soon found she has similar interests and followed in their footsteps. After spending about ten years working in the insurance industry as both an appraiser dispatcher and a senior property claims adjuster, she decided to combine her years of insurance experience with another...
Insurance Claims Support & Sr. Adjuster
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.