Vasectomy Counseling Video

Physician Training

On-line Vasectomy Registration

Vasectomy - General Information Vasectomy - In Our Practice
Vasectomy is ... TheTechnique of Drs. Doug Stein and John Curington
Before vasectomy ... Instructions for Before & After Vasectomy
Methods used to perform vasectomy Fees
After vasectomy ... Financial Aid  Title X (Ten)
Risks of having a vasectomy ... Scheduling Your Vasectomy
Limitations and advantages of vasectomy Counseling Video

Vasectomy is...

Developed as a means of contraception in the early 20th century, and popular (500,000 procedures per year) since the 1950's, vasectomy is a dependable method of birth control for men who think they will never want any or any more children. It is a simple 15 minute procedure performed in a doctor's office or clinic with a local anesthetic. The objective is to prevent sperm from entering the semen, 95% of which is support fluid made by glands called the prostate and seminal vesicles, located in the pelvis behind and beneath the bladder (anatomy diagrams).

Before Vasectomy...

Sperm are made in the testes. From each testis, sperm move through a long curled-up tube behind the testis (the epididymis) wherein they become mature. From there, they swim up a foot-long tube (the vas) which guides them up to the channel (urethra) through which men urinate and ejaculate. Just before entering the urethra, the left and right vas tubes are enlarged, and it is here, behind the bladder, where many sperm are stored between ejaculations. The easiest place to access the vas tubes is just above the testes where the vas tubes are just beneath the thin scrotal skin, easy to feel and very mobile.

Methods... (Our preferences are below)

Anesthesia: An anesthetic solution can be injected with a tiny needle to numb the scrotal skin and the vas tubes, or a pressure spray applicator can be used to numb the skin and vas tubes without using any needles.

Access: During conventional vasectomy, one or two 1/2-inch scrotal incisions are made to gain access to the vas tubes. These incisions are later closed with sutures, which remain in place for about 5 days until they dissolve or are removed. During no-scalpel vasectomy (NSV), special instruments are used to perform the procedure through a single tiny access-opening on the front side of the scrotum. The 1/4-inch slit usually seals within hours, so no stitches are needed.

Blocking the vas tubes: Whichever technique of accessing the vas tubes is used, each vas (left & right) is divided about one inch above each testis, where it is just beneath the thin scrotal skin and very easy to reach. What is done with the ends of the divided vas tubes depends on the preference of the person performing the vasectomy. Some operators remove a piece of vas; others don't. Some tie off one or both vas ends using permanent or absorbable sutures or the small clips used to stop bleeding blood vessels during other types of surgical procedures; others cauterize the ends so that they will seal by scarring. Still others simply place the divided ends out of alignment, by closing the vas sheath between the 2 ends with a suture or tiny clip so the ends won't grow back together.

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After Vasectomy...

The portions of the vas tubes within the pelvis still contain live sperm until they are all released. About 98% of men are sperm-free after 20 ejaculations and 12 weeks. In 5% of men, the semen may still contain some sperm (usually few in number and not active) for months, so it is important to have a semen sample checked and to use other forms of birth control until it is confirmed by microscopic examination that the semen is sperm-free.
Sperm are still made by the testes but can no longer pass up through the vas tubes (anatomy diagrams). So the body adjusts: white blood cells ingest and digest the retained sperm, recycling the proteins back into the system for use in other body functions. Men usually notice:
  • No change in the semen

  • No change in sex drive

  • No change in climax sensation

  • No change in the testes or scrotum

  • No change in erections
For more details about changes after vasectomy in our patients, please see the results of our 2006 survey, and our second survey of 2010. In fact, a recent study concluded that vasectomy positively impacts the sexual satisfaction of couples.

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Risks...

Bleeding can occur during or after vasectomy by either method, but it is less common with NSV. If this occurs within the scrotum, drainage of a scrotal hematoma (blood clot) in a hospital operating room could be necessary. Smaller hematomas do not require surgical drainage, but tender swelling can last for 2 to 4 weeks. Both large and small hematomas are very rare. If the scrotal skin bleeds at the vasectomy access site, the scrotum can become discolored (black and blue) for about a week; this is more common than swelling, but painless.

Infection is also a rare complication. Among the first 24,000 vasectomy patients served by Dr. Stein, six infections have occurred (infection rate 1 in 4000): two patients had prolonged discomfort and progressive swelling on one side, not responsive to oral antibiotics, eventually maturing to a painful walnut-sized abscess requiring office drainage through a half-inch incision and a two-week period of local wound care. Four other milder infections (swelling unresponsive to anti-inflammatory medications) responded to oral antibiotics.

Sperm granuloma is a pea-sized (sometimes tender) lump on the vas tube at the vasectomy site, almost never requiring treatment. Some consider sperm granulomas beneficial, as they may increase the likelihood of success with vasectomy reversal. Periodic tenderness usually responds to an anti-inflammatory medication like ibuprofen, but over the past decade, 5-10 men been so troubled by chronic tenderness that they chose to undergo removal of the lump, an office procedure performed under local anesthesia similar to the original vasectomy.

Congestion, tender buildup of sperm and white blood cells upstream from or at the vasectomy site, can occur anytime after vasectomy, but usually goes away with use of an anti-inflammatory drug such as aspirin or ibuprofen. About one in 2000 patients will experience chronic post-vasectomy discomfort (PVPS or Post-Vasectomy Pain Syndrome) severe enough that he will seek vasectomy reversal or neurolysis (division of the sensory nerves coming from the testes). A larger percentage may have milder forms of chronic pain that can affect quality of life but not severely enough to seek vasectomy reversal.

Recanalization is the development of a channel for sperm flow between the two cut ends of the vas. If this happens during the healing process (early), the semen never becomes sperm-free until the vasectomy is repeated. If recanalization happens late (months or years after a man's semen has been examined and declared sperm-free), an unplanned pregnancy could result; but the odds of this occurring is far less after vasectomy than the odds of pregnancy with any other form of birth control including birth control pills and tubal ligation (female sterilization). Failure rates of vasectomy vary with the technique used to obstruct sperm flow through the vas tubes. In our practice, the early failure rate is about one in 2500 and the late failure rate is one in 3500 (details here).

There are no proven long-term health risks (neither cancer nor cardiovascular disease) associated with vasectomy, but since questions have been raised, they are addressed in our page of Frequently Asked Questions.

The risks of NOT having a vasectomy are all borne by the partners of men who choose to avoid vasectomy. And they are considerable!

Limitations of Vasectomy...

  • Not 100% reversible *
  • Must use other forms of birth-control until sperm-free.
  • Does not prevent transmission of sexually transmitted infections (STI's).

Advantages of Vasectomy...

  • Low one-time expense often covered by insurance companies, and by federal grant money through state programs for low-income men with no insurance (see Florida Providers).
  • More dependable than any other form of contraception including female sterilization.
  • Eliminates risks associated with birth control pills or shots and the IUD.
  • Vasectomy reversals are less costly and more successful than tubal ligation reversals (see Vasectomy Reversal).
  • No need for inconvenient and less dependable methods, so there are...
    no more worries!!!!

* - Since reversal attempts often do not lead to pregnancy, vasectomy should be considered an irreversible form of contraception. Statistics show that men who undergo vasectomy in their 20's are more likely to seek vasectomy reversal than men who have vasectomies later in life. In fact, men in their 20's and with fewer than 2 children should read our Special Message for young men. Before choosing vasectomy, couples, especially couples in their 20's with fewer than 3 children, should consider all other forms of reversible contraception including birth control pills, shots, patches, and implants ; the IUD (intrauterine device); and barrier methods such as the condom and diaphragm. A nice review of these options is in the Planned Parenthood website, and HERE in VasWeb. Couples using barrier methods should also be aware that, for those occasions when they are just "careless", EC (emergency contraception, or the "morning after pill") is readily available at most women's health services sites such as private primary care and gynecology offices and Planned Parenthood clinics. EC is effective at preventing pregnancy for up to 72 hours (perhaps longer) after the "careless" encounter (visit www.not-2-late.com for a list of EC providers in your area). Men should not proceed with vasectomy if they feel they are being pressured to do so, if their private lives are temporarily unstable due to marital discord, or if they have not considered all reversible alternatives. For many stable men, circumstances change, and all men, especially younger men, should consider sperm storage as insurance against regret over vasectomy in the event of a major life change. If you have never caused a pregnancy, how do we know that you even need a vasectomy ... or what we should expect if you ever opt for vasectomy reversal? Please see our Special Message for Men Who Have Never Caused a Pregnancy.

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Drs. Stein and Curington use the no-scalpel technique, exposing each vas in turn through a tiny opening in the front scrotal wall under local anesthesia. Since the opening is so small, it is easy to apply anesthesia without the use of needles. A spray applicator (MadaJet®) delivers a stream of anesthetic so fine that it penetrates the skin and diffuses to a depth of about 3/16 of an inch, enough to surround and anesthetize each vas tube in turn as it is lifted into position beneath the skin. Most, about 99%, of patients require no more anesthetic than this for completion of the procedure itself without pain. Some, about 1%, of patients do require injection of a little more anesthetic, but since the skin and vas are already partially numb, injection of more anesthetic with a fine needle rarely causes more than the slightest sensation. The tiny opening in the dime-sized area of numb skin is made with a pointy hemostat: one tip makes a pinpoint opening, then the two tips are used to spread and enlarge the opening to about 1/4 of an inch. Since blood vessels in the skin are spread apart rather than cut, bleeding is less than when a scalpel is used, no stitches are required, and the opening is usually sealed closed (often barely visible) by the next day.

Once each vas tube is lifted through the small skin opening, it is divided under direct vision with fine surgical scissors. Nothing is removed; the ends of the divided vas are placed out of alignment and kept from rejoining by applying a tiny clip to the sheath surrounding the vas so that one end stays inside the sheath, the other outside. While extremely effective (failure rate less than 1 in 2000), the technique provides for easier reversal (less scarring than when sutures are used) in men who choose reversal later in life. Procedure time is about 15 minutes. Most men say it hurts less than having a blood sample drawn. Many have called it painless. (In an e-mail, one patient recounted his experience step-by-step here.) A scrotal support (jockstrap) is applied and should be worn overnight and reapplied, after a next-morning shower, when up and around for the next 2 days. Ice-packs are not necessary. Men are advised to recline on the evening of the vasectomy, light activity the next day, sex and full activity 2 days after the vasectomy. After vasectomy about half of men will take non-prescription pain pills (Tylenol or ibuprofen), often just to prevent expected discomfort; the other half don't take any pain pills. About 1 in 1000 men will have enough discomfort to request a prescription pain medication. Semen samples can be brought or mailed (we provide the mailers) to the office twelve (12) weeks after the procedure to see if all stored sperm have been passed. Ninety-eight percent of men are sperm-free after 12 weeks and 20 ejaculations, some sooner, and a few men will not be sperm-free for 5 or 6 months. Evaluation of semen samples is included in the price. A copy of our vasectomy instructions and consent is available below and here as a PDF file.

INSTRUCTIONS BEFORE VASECTOMY
  1. If your partner has already had a tubal ligation (female sterilization), of if she is pregnant now and may have a tubal ligation during a Ceasarean delivery, please read this Special Message.
  2. Understand the Alternatives to Vasectomy so that you are confident in your choice.
  3. Understand the "Instructions Following Vasectomy" below so that you know what to expect.
  4. Please shave the underside of the penis and the front wall of the scrotum, preferably before the day of the procedure. A bit of alcohol is used to clean the skin before use of the MadaJet® and it can sting slightly right after a fresh shave if the skin is chafed.
  5. Use no powder or deodorant in the genital area on the day of your procedure.
  6. No need to bring an athletic supporter. One will be provided.
  7. Be prepared to sign the operative consent sheet (part of the PDF file in the paragraph above) upon your arrival in the office.
  8. If possible, arrange to have someone drive you home. A flat tire or fender bender could lead to complications, and some men who leave the office feeling great will experience delayed lightheadedness. If you must drive yourself, drive in the right-hand lane so that you can pull over if you begin to feel lightheaded. Plan to do nothing but recline at home (sofa or bed) on the afternoon and evening of the vasectomy.
  9. Plan to do nothing but recline at home on the evening of the vasectomy.
  10. Do not take any aspirin-containing medication for five days before the procedure.
  11. If your insurance company or HMO requires authorization, be sure to bring it or call our office (813-972-1365) a day or two before your vasectomy to see whether we have received it. If your procedure is covered through a county health department under Title 10 (see below) and scheduled at a facility outside the health department, call us to be sure we have received the paperwork.
  12. To save time on your procedure day, please watch the Online Counseling Video and complete our Online Registration Form.
  13. Eat before your procedure, a normal breakfast or lunch. Nervous men who do not eat beforehand are more likely to become lightheaded during or after their vasectomies.
  14. Prior to the procedure, payment of $590 is required of those paying cash, a $100 deposit when filling out the online registration and $490 immediately before the procedure. At the time of service, a co-payment and/or contracted fee will be required of insured men who have not met their deductibles. After we hear from your insurance carrier, we will refund your deposit less your co-payment, and we will issue a refund if your insurance pays after you did.
INSTRUCTIONS FOLLOWING VASECTOMY
  1. Spend a quiet evening at home, reclining in bed or on the sofa. Minimize activity. Some men have no pain at all after vasectomy. Many have mild discomfort that does not require pain pills. Sometimes the discomfort is in the groins or abdomen. That's because the testes originate in the abdomen in embryonic life and drag their nerve supply with them as they migrate into the scrotum. So any issue in the scrotal contents can be perceived as an abdomenal process.
  2. Avoid aspirin for 2 days after the vasectomy. You may take acetaminophen (Tylenol or generic) if you have any discomfort. Ibuprofen (Motrin, Nuprin, Advil or generic) and naproxen (Aleve) are both pain medications and anti-inflammatory drugs. For the first few days after a procedure, inflammation may be a normal component of the healing process, and I prefer not to stifle it, so Tylenol is preferred. Pain beyond 3 days, especially if accompanied by some swelling of the vasectomy sites above the testes, may signify excessive inflammation and then ibuprofen and naproxen are good choices. Some men will have more discomfort or tenderness 3-5 days after the vasectomy than they do for the first few days after their vasectomies. That's because the body goes through a series of steps in responding to the new arrangement, and sometimes the later steps are more noticable than the earlier steps. Ususally no reason for concern.
  3. No need for ice packs, unless you really enjoy having ice on your scrotum.
  4. You may remove the scrotal support and take a daily shower starting the morning after the procedure. Replace the scrotal support and wear it whenever you are up and around for the next 2 days, during sports for the next 7 days.
  5. On the day after the procedure, you may walk and drive as much as you like, but no sports, yard work, swimming, or heavy lifting. If your job is sedentary (office work or supervisor), you may return to work.
  6. Two days after the procedure, you may return to more strenuous work and regular activities wearing your scrotal support. When pain is gone and tenderness is minimal, you may return to the gym or to running, but on the first day back, do ½ of your usual workout: half the weight, half the reps, half the speed, half the distance, etc. If pain does not return, you may do your regular workout the next day.
  7. When you no longer have any pain or tenderness, you may ejaculate. I have always recommended waiting at least 2 days for sex, but the American Urological Association Vasectomy Guidelines recommend that men wait a week. It is unclear whether sooner ejaculation prolongs discomfort. Blood in the semen within the first month or two after the vasectomy occurs in some men, but also no reason for concern.
  8. Since no incision is made, a no follow-up visit is required. You will be given Dr. Stein's home phone and cell phone numbers and if you have undue discomfort or any concerns, you should call him anytime after your vasectomy.
  9. It is normal to have some discoloration of the skin (black and blue) around the puncture site a day or two after the vasectomy. Some men will develop considerable discoloration of the scrotum about 4 days after the vasectomy. Blood from the deep vasectomy site comes to the surface as a purplish-blue mark, gets darker and spreads out like an oil slick, then gradually dissipates.
  10. Some men (about one in 20) will develop swelling and discomfort on one side, sometimes on both sides, starting anytime from 3 days to 3 months following vasectomy. This usually represents an exaggerated form of the normal inflammatory response necessary for sperm resorption and recycling. It is effectively managed with a 5-7 day course of ibuprofen 600 mg 3 times per day.
  11. Twelve weeks after your vasectomy, have your semen tested to be sure that it no longer contains sperm and that it is thereby safe to stop other forms of contraception:
    1. If your vasectomy is performed at a location other than the home office in Tampa, we will provide you with a mailer so you can send us a semen sample by mail, at least twelve (12) weeks and 20 ejaculations after your vasectomy (number of ejaculations and number of weeks are both important). The container provided contains a bit of antibiotic so that the sample does not become overgrown with bacteria. Call us at 813-972-1365 a few days later for the results. If you send in your specimen before 12 weeks or if you lose the mailer provided at the time of the procedure, we will send to you another mailer for a fee of $10 payable by credit card over the phone.
    2. If your vasectomy is performed at the home office in Tampa, testing is done in one of two ways:
      1. If you live or work close to the office, we will provide you with a container and ask you use it to bring a semen sample to the office 12 weeks and 20 ejaculations after your vasectomy. (Number of ejaculations and time are both important, so a semen sample brought in before 12 weeks is less likely to be free of sperm.) If you lose the container that we provide, you may use a small container with a lid, such as a pill bottle, baby food jar, 35 mm film canister, etc. Please do not bring the sample in a condom or baggie as we will be unable to retrieve an adequate specimen and you will be asked to return with another sample in a container with a lid. The sample should be produced on the day of examination, but can be 3 or 4 hours old. You may bring the sample anytime during regular office hours (9:00 - 4:00), and we will tell you within 5 minutes if you are sperm-free. If sperm are seen, you will be asked to continue other means of birth control and to return with a second specimen in 2-3 weeks. After twelve weeks and 20 ejaculations (both), 98% of men will have no sperm in their semen. Two percent will have to repeat the test at least once.
      2. If you live and work far from the Tampa office, we will provide you with a mailer so you can send us a semen sample by mail, at least twelve weeks and 20 ejaculations after your vasectomy. The container provided contains a bit of antibiotic so that the sample does not become overgrown with bacteria. Call us for the results at 813-972-1365 five days after you mail the specimen. If you send in your specimen before 12 weeks or if you lose the mailer provided at the time of the procedure, we will send to you another mailer for a fee of $10 payable by credit card over the phone.
  12. Finally, feel free to write a review HERE.
Description Fee
Vasectomy consult and procedure
$590*
Vasectomy reversal consult $100
Vasectomy reversal procedure
$5900

*This is a discounted rate for patients who pay with cash, check, or charge card. When we apply for payment to insurance companies, a higher standard rate structure is used. Because of this discrepancy in fees, we are required by Florida statute to inform you of the following: THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT.
**According to the Federal Tax Code, the expenses of attaining medical treatment to correct a functional impairment (sterility in the case of vasectomy reversal) are tax-deductible once the total medical expenses for the tax year (including what is spent for health insurance) exceeds 7.5% of adjusted gross income. This includes the reversal fee, airfare, mileage expenses at $0.50 per mile, and lodging expenses up to $50 per night.

Note: On Thursday October 5 and Friday October 6, 2017 at his Tampa office, Dr. Stein will host a training day for Dr. Stacy De-Lin, a Specialist in Reproductive Health with Planned Parenthood in New York City. Dr. De-Lin would like to  be able to add vasectomy to the list of services that she provides to patients at Planned Parenthood. Observation is helpful, but there is no substitute for "hands-on" training. Vasectomies performed while Dr. Stein trains another physician usually will take about 40 minutes, whereas Dr. Stein's routine vasectomy procedure takes 10-15 minutes. So we are looking for men with patience and a desire to save $200.00 (34%) off the usual vasectomy fee. Since Drs. Stein and De-Lin will work together on each patient, there should be no increased risk of either complications or pain, but there will be more manipulation of the vas tubes as Dr. Stein shows Dr. De-Lin his technique to position, anesthetize and access the vas on each side. Patients will hear Dr. Stein explain the procedure. Some hardy men will even be interested enough to lift up on their elbows and observe, which is always fine with Dr. Stein. Because of the reduced rate and the need for men who are not likely to postpone to a later date at the last minute (Dr. De-Lin cannot learn on men who don't show up), we ask for a non-refundable deposit of $100 at the time that September 19 & 20 procedures are scheduled. Thank you.

Note: On Monday October 16, Tuesday October 17, and Wednesday October 18, 2017 at his Tampa office, Dr. Stein will host a training day for Dr. Larry Bull, a General Practitioner in  Gympie, Queensland, Australia.

Note: On Monday November 6, Tuesday November 7, and Wednesday November 8, 2017 at his Tampa office, Dr. Stein will host a training day for Dr. Wagdi Nagib, a General Practitioner in  Mount Martha, Victoria, Australia.

Note: On Monday December 11 and Tuesday December 12, 2017 at his Tampa office, Dr. Stein will host a training day for Dr. Jose Trevino, a General Surgeon in Plano, Illinois.

At all locations, a deposit of $100 is required to schedule a vasectomy, unless your procedure is being covered under Title 10 (see below) through your county health department. Except for training cases, the deposit is fully refundable until 7 calendar days prior to the appointed vasectomy date, non-refundable thereafter for either cancellation or postponement. Later cancellations leave us with open appointments that might gladly have been taken by men who had to choose later dates because of full schedules on earlier dates, but those same men cannot take open dates with less than one week notice.
Private Health Insurance
Health insurance often covers vasectomy. Health insurance COMPANIES sell a variety of health insurance PLANS. Within the same company, some plans may cover and others may not. And even if a plan "covers" vasectomy, it will not "pay" for a vasectomy if the plan-holder has not met his deductible. However, even when the deductible has not been met, the patient owes no more than the "allowable" for vasectomy under our contract with his insurance company. Here are some examples of "allowables" as of August 29, 2016 (always subject to change): Aetna $448.82; AvMed $450.00; BCBS $484.83; Cigna $460.45; United $493.27.

So ... If you have private health insurance (as opposed to Medicare or Medicaid), call your insurance company (the phone number should be on the back of your card). Obtain and save the name of the representative. Here are the important questions:
  1. Is vasectomy covered under my plan? If they need it, the procedure code is 55250; the diagnosis code is Z30.2; and our tax ID number is 59-2549110.  Be sure that you make it clear that this is an OFFICE procedure and NOT an OUTPATIENT procedure (to insurance companies, "outpatient" means done in an outpatient operating room facility). If vasectomy is not covered under your plan and if your income is low, you may seek assistance under Title 10 (see below) or plan to cover the cost yourself. If vasectomy is covered ...
  2. ... Do I have a deductible and how much of that have I already met this year? (You may be told by the insurance company rep that "it is a covered procedure with just a copay". You MUST ASK about a deductible; otherwise, you may be very disappointed to get a bill that you did not expect.) If I don't have a deductible or if I have already met it ...
  3. ... Does my plan require that I use only "network" doctors contracted with the plan? If so ...
  4. ... Is Dr. Stein one of the contracted providers under my plan? If not ...
  5. ... Is there any "out-of-network coverage" for procedures by doctors who are not in the plan's network?
Again, get the name of the person with whom you speak. We bill insurance companies $700, as opposed to $590 for direct pay patients. If you are told that you have coverage under your plan, we will verify that* and bill your insurance company directly. If we are told that your deductible has not been met, you will be asked to pay the plan's "allowable" at the time of the procedure. It's important that you have the name of the company representative, so that he or she can be held accountable Sometimes the insurance company denies payment after the insurance company rep (a person or website) indicated that vasectomy is a covered procedure and that the patient either has no deductible or his deductible has been met. The patient then receives a surprise bill from us for the insurance company's allowable amount. If unpaid, it goes to collections, so do not proceed with the vasectomy if you don't want to take this financial risk. As of December 2016, Drs. Stein and Curington are contracted providers under many plans offered by, among others, the following companies: Blue Cross PPOs & Blue Options (not HMOs and Blue Select), Cigna PPO and HMO (not BayCare), AvMed, United HealthCare, and Aetna. Patients with Blue Cross HMOs and Blue Select are offered the Blue Cross rate of $484.83; and patients with Cigna-BayCare are offered the Cigna rate of $460.45. We are NOT providers with Humana/TriCare because their allowable rates are SO much lower than those of other companies. We are told that Humana/TriCare does cover vasectomy through their contracted providers, sometimes with no deductible. For pateints with Humana, we offer the United rate of $493.27.
* - We will not verify coverage for those with BCBS of South Carolina (held by many Publix employees) and BCBS of Illinois because the verification processes for BCBS-SC (800-334-2583) and BCBS-IL requires that our caller listen to a seemingly endless recording of unrelated codes. Those with BCBS-SC and BCBS-IL will be asked to pay the allowable up front and will be reimbursed when and if we are paid by BCBS-SC or BCBS-IL.
Why a deposit policy? Without a deposit policy, a number of patients will cancel or postpone within a few days of their appointments, often after we have denied those appointment times to other patients. With a deposit policy, there is no need to overbook to compensate for no-shows. Also, patients with insurance often have copayments, and it is easier for us to refund the deposit less copay than it is to bill patients for their copayments. We also get more compliments than complaints about the policy: "I walked out of appointments twice with prior doctors, Doc, and I regretted it both times. But I wasn't about to walk away from $100, so you helped me accomplish what I knew had to be done."

Medicaid
We have learned that, when it comes to procuring vasectomy services, Medicaid can be more of a hindrance than a benefit. Some county health departments will deny Title 10 funding for patients who are on straight Medicaid or enrolled in Medicaid HMO's. Medicaid has a reputation of paying so slowly that few doctors wish to participate. Certain county health departments participate, but they may require referral authorizations from the Medicaid primary care physicians, and getting a referral authorization may be discouragingly slow. Dr. Stein was but is no longer a Medicaid provider of vasectomy services because the reimbursement is low ($143) and the paperwork unbearable. (Three claims were recently denied because we used abbreviations: Dr. Stein's middle initial "G." and "M.D.", rather than "George" and "Medical Doctor".) However, some county health departments will offer Title 10 financial assistance (see below) to men with Medicaid if there are no local providers of vasectomy services under the Mediciad program.

Medicaid tries to shift all Medicaid patients to Medicaid HMO's, sometimes without the Medicaid recipient even being aware of the shift. Drs. Stein and Curington are not contracted providers with any Medicaid HMOs, as some Medicaid HMO administrators have done exceptionally well financially, and we do not want that financial success to be at our expense. Staywell is one Medicaid HMO in Florida, parented by WellCare. Staywell's website clearly states that, "Sometimes we may not have a provider in our network who can give you needed care; if this happens, we’ll cover the care out-of-network (at no additional cost to you), but you will need to get approval first from us or your PCP." We have had patients report that their primary care doctors discouraged vasectomy as overly risky or denied that vasectomy is "needed care". But vasectomy is "needed" to reduce the risks to your partner of female-oriented contraceptives and the unintended pregnancies that occur with failure of those less-dependable choices. Not offering a service saves plan money, especially if a member's partner is still on straight Medicaid and WellCare would not have to pay for future pregnancies. So stand up for your rights and insist on coverage. If they say they have no vasectomy provider, insist on out-of-network coverage, and call us if they give you a hard time.

Title X (Ten)
If your income is low and you have no health insurance that covers vasectomy, Federal Title X (Ten) grant money is available in Florida and nationwide to help fund family planning services, including vasectomy. Most if these federal Title X funds are allocated through county health departments. Please see our Guide to Florida Health Department Vasectomy Programs. If you live in a county whose health department has no vasectomy program or no federal funds available for vasectomy, you may apply for financial aid through the health department of a neighboring county. Tampa Office:

At our Tampa office (click for location and directions), we have 30 time slots available for vasectomy most weeks, so we can usually see any candidate within one week of his call.

Because there is so much information here in vasweb.com, especially with the online counseling video, we do not require preliminary consultation visits and most men opt for only one visit. If you would like to visit the office and meet Dr. Stein personally before deciding to proceed, we would be delighted to see you twice. (In fact, Drs. Stein prefers to consult with childless men in their 20's either in person or by telephone at least one week before their vasectomies to thoroughly discuss the issues here.) If the consultation and vasectomy are on separate days, either can be done on any weekday. At the Tampa office, Tuesday, Thursday, and Friday afternoons are the designated vasectomy times, but we will try to accommodate your schedule if these times are inconvenient for you. In-person consultations take 10-15 minutes and vasectomies take 15-20 minutes.

All scheduling is done by Vivian and Sergio at 813-903-1902 (or toll-free 866-827-8463) between 9 AM & 4 PM M-F. They can also answer many technical and logistical questions.

Outfield Locations:

As you may have seen in the Florida map on our Index Page, Drs. Stein and Curington perform vasectomies at a number of locations in peninsular Florida. A complete schedule with links to maps and information about these locations is in our schedule page.

Registration:

When you arrive at either the Tampa office or at one of the outfield locations (except county health departments), you will be asked to provide demographic and health history information as you are at any doctor's office. You may now register online before your visit. The benefits are numerous and listed in our On-line Registration Page. (Please do not hit SUBMIT more than once. Contact our office if there is any doubt that the registration went through.)

Send vasectomy questions via our Visitors Page, or call 813-972-1365 or toll-free 866-VAS-TIME (that's 866-827-8463).
Dr. Stein answers queries to the Visitors Page from home and can usually respond within 24 hours.
Thank you.
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