Living in Frisco, Texas, and considering a vasectomy? While Dr. Buch no longer participates with insurance plans, we provide exceptional service and traditional doctor-patient relationships. We understand your desire and need to optimize the value of your health insurance investment. Unfortunately, we are unable to give you the exceptional standard of quality treatment that you deserve while complying with the significant load that health insurance companies currently put on their providers. We hope you understand, and we will provide you with outstanding service.
This section aims to provide our readers with some guidance in understanding the complexities related to insurance plans or policies. It shall not be construed as a replacement for your actual insurance benefit description. Paying your insurance premium does not guarantee insurance benefits!
There are three significant caveats we'd like to share with you:
- Know what your insurance benefits are. It is not an acceptable excuse to be unaware that something was not covered by your insurance plan or that a representative at your insurance company verbally misinformed you.
- Benefit verification by any insurance company, whether by phone or otherwise, is not a guarantee of payment (some insurance companies have recorded disclaimers to this effect, while others require the live representatives to state the disclaimer verbally).
- You are ultimately held financially responsible to the Provider of Service should your insurance fail to pay any insurance claim.
The individual must understand the plan's coverage restrictions for reimbursement of out-of-network benefits for consultation and procedures done by out-of-network providers. We highly advise our patients to consult their insurance policy brochure or manual and contact their insurance carrier directly if they have any issues.
Most insurance plans usually cover the cost of having a vasectomy. However, the benefits provided by insurance plans vary widely. Therefore, only a brief summary will be contained in this section. In general, group plans offer better benefits over individual plans, and benefits may differ from plan to plan even when provided by the same insurance company.
An office consultation is scheduled on a day, at least 48 hours before vasectomy. Our current charge for a New Patient Office Consultation is $300. Depending on your group plan, you may only be responsible for a Specialist Office Copay. Some plans have different Copay amounts when the rendering physician is a specialist. Other plans may have a calendar year deductible and a percentage (coinsurance) of the allowed amount or a combination of an office copay and coinsurance. Sometimes, the insurance plan will not cover (or provide any benefits for) the office consultation. For instance, some individual insurance plans may only offer catastrophic coverage. Don't hesitate to contact your insurance company directly to verify your benefit for this type of service, and refer to your insurance benefit manual or plan description.
The actual vasectomy is normally an office procedure performed on a different day. Our current charge for vasectomy is $1100. In some instances, this may be covered under the Specialist Copay, deductible and coinsurance, or a combination of both. At times, the vasectomy is not covered by the plan. Please refer to your benefits handbook, and verify your coverage for vasectomy directly with the insurance company.
If you're considering a vasectomy, we're here to help you navigate the complexities of insurance coverage. Contact us at
(972) 996-7177 to learn more about your financing options and avoid financial responsibility.
