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Health insurance for sterilisation
Many health insurance policies will cover a range of male and female sterilisation procedures such as vasectomy, tubal ligation and hysterectomy. Compare policies with sterilisation cover from around $21 per week.
There are a range of private cover options for the common sterilisation and sterilisation reversal procedures.
Simple procedures like vasectomies are covered under many Bronze health policies.
More complex procedures like hysterectomies may require a top-tier plan.
Health insurance policies for sterilisation
Below you'll find a selection of Finder partners that cover sterilisation, and the minimum policy tier that covers the treatment. All have a two-month waiting period. All prices are based on a single individual with less than $93,000 income and living in Sydney.
Standard cover (a varied mix of hospital
treatments)
Comprehensive cover for most treatments
Pregnancy and childbirth
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What are the main types of sterilisation available?
In general, if someone never wants to have children then sterilisation can be an effective option. The two most widely-used methods of voluntary sterilisation are:
Vasectomy
A vasectomy involves a man having his vas deferens severed or sealed. This prevents him from impregnating women with no major impact on sexual functioning. The procedure does not require hospitalisation and can usually be performed in 30 minutes or less.
Tubal ligation
This procedure involves the surgical severing and/or blocking of a woman's fallopian tubes. This prevents the passage of eggs to the uterus and renders pregnancy near impossible.
In Australia, it is illegal to undertake either of these procedures on persons under the age of 18 unless it is a clear medical necessity. Needless to say, no health insurance will cover illegal procedures.
If you think you might want to undo your vasectomy or tubal ligation in the future, then do not get it at all.
Reversal surgery does not guarantee that you will recover full functionality, and in some cases will be completely ineffective. The high costs and indeterminate success rates of sterilisation reversal procedures mean that private health funds will typically only cover them as on more comprehensive policies.
Finder survey: What are the main reasons Australians have hospital insurance?
Response
To avoid public surgery waiting lists
44.76%
Source: Finder survey by Pure Profile of 1006 Australians, December 2023
How does health insurance handle contraceptive surgery?
Private health funds will cover vasectomies, tubal ligation and hysterectomies in varying ways, depending on the level of cover you have purchased and the conditions of the policy. Things to consider are:
Your level of cover. Because sterilisation is an elective procedure, vasectomies and tubal ligation are typically covered under higher-tier hospital policies. Check your health insurance policy's Product Disclosure Statement (PDS) or contact your fund to find out if your policy covers it.
Your hospital cover. Vasectomies do not usually require hospitalisation, but tubal ligation does and hysterectomies in particular require spending several days in hospital. Hospital stays will incur additional costs. To find out how a private health fund covers these and the limits which may apply, look at the hospital cover section of the policy. It is possible that your health fund will cover the surgery itself, but won't cover the hospital stay and related costs.
What sterilisation covers. Sterilisation typically refers to tubal ligation and vasectomies. Sterilisation is the term to look for if you want a private health fund to cover your contraceptive surgery, and it is a good idea to familiarise yourself with the terms and conditions surrounding it.
What gynaecological services covers. In both the hospital and general cover sections you may find that a policy includes gynaecological services. Typically this refers only to medically necessary services, like emergency hysterectomy, and not elective ones like tubal ligation.
What fertility and infertility services mean. Fertility and infertility services, although related to sterilisation, are not connected to the contraceptive surgeries on offer and do not cover vasectomies or tubal ligation (which are sterilisation) or hysterectomies (which is a gynaecological service). However they do refer to vasectomy or tubal ligation reversal surgery, which is a procedure to undo sterilisation.
Can't I just get these types of medical service under Medicare?
So, it's not usually worth choosing a fund on the basis of whether or not they cover these. However, going private may still be worth considering if:
You only want to see a particular practitioner for your vasectomy or tubal ligation.
You don't want to wait for a bulk-biller to fit you in.
You are considering an elective hysterectomy for reasons such as a family history of cervical cancer.
How do I claim sterilisation services on health insurance?
To claim a vasectomy or tubal ligation with a private health fund:
Make sure your chosen doctor is approved by the health fund.
Book an appointment and confirm that they work with your fund.
Pay them in a way approved by the insurance plan. This may be by simply swiping a health fund membership card, giving them your details, or paying up-front and then claiming it back later.
Claiming a hysterectomy can be more complicated as it depends on your reason for having the procedure and the methods used by the surgeon.
Bottom line
Having a vasectomy or tubal ligation procedure is easy and relatively inexpensive, but it should also be considered very carefully first. Covering sterilisation with public or private health insurance is simple, but undoing it can be much more complex and expensive.
How much does health insurance cost?
We ask hundreds of Australians what they're paying for health insurance every month. Here's what they told us in May 2024.
Basic: $116
Bronze: $143
Silver: $168
Gold: $209
Price based on 1,000+ responses for single hospital insurance.
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Frequently asked questions
The two most widely-used methods of voluntary sterilisation are tubal ligation and vasectomy. A hysterectomy, which removes a woman's uterus, is also a common operation.
Exclusions are conditions where your policy will not pay a benefit. Before getting waist-deep in the world of contraceptive surgery, study your health insurance policy and look for these details in particular:
No payout for procedures done outside of Australia.
No cover for additional costs like hospital meals or administrative fees.
No cover if the treatment isn't curing a specific problem. Hysterectomies, for example, might not be covered if undertaken to reduce the future odds of cervical cancer because that is not an immediate problem. On the other hand, tubal ligation might still be covered even though it's non-essential because it is "curing" the "problem" of fertility.
A limit is the maximum amount that your insurance policy will pay out. There are typically a variety of different maximums active simultaneously:
A maximum amount that the insurance fund will ever pay for any procedure
A maximum dollar amount or number of treatments that can be claimed in a year
A maximum number of procedures or dollar limit of treatments per person
A maximum number of benefits that can ever be claimed over the course of the entire policy
You must pay the total flat sum of all applicable excesses when making a claim. Typically, there will be more than one:
A standard excess that applies to all claims made by any customers of that fund
An extras excess for claiming ancillary cover features
Hospital excess to cover the fund's additional expenses associated with your hospital visit
A special excess which applies depending on special circumstances, pre-existing conditions etc.
James Martin was the insurance editor at Finder. He has written on a range of insurance and finance topics for over 7 years. James often shares his insurance expertise as a media spokesperson and has appeared on Prime 7 News, WIN News, Insurance News, 7NEWS and The Guardian. He holds a Tier 1 General Insurance (General Advice) certification and a Tier 1 Generic Knowledge certification, both of which meet the requirements of ASIC Regulatory Guide 146 (RG146).
Want to get health cover for grommets? Find out how private health insurance and Medicare costs compare and what you'll be covered for. Choose the option that suits you best.
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