top 200 commentsshow all 469

[–]Deuce232[M] [score hidden] stickied comment (0 children)

The OP is asking 'why would an insurance company consider one thing that prevents pregnancy different than the other thing that is similar?'

That's been covered well.

This thread is not about the effectiveness of either method. It isn't about why insurers are allowed to function in the way they are in the US. It isn't about anyone's anecdotes about their surgeries.

In this sub replies directly to the OPost are restricted by rule 3.

All the things I listed are pretty hunky-dory as replies to comments though so those discussions happen there.

Not everybody from outside of our little community is hip to that and we just don't have enough mods at 3AM PST to attend to all the reports, so bear with us if you find the thread locked for a while.

As always, I am not the final authority on any of this. If you want my mod-action reviewed you can send a modmail. If you want to have a meta-conversation about the rules of the sub you can make a post in r/ideasforeli5 which is our home for that.

[–]nicold89 242 points243 points  (14 children)

Others have explained generally why it should be the case, however the precise reasons is they are required to by law.

If the ACA didn't mandate it, it wouldn't be paid 100%. Trump added a religious exception, but normally all FDA approved contraceptive methods must be covered. Including voluntary sterilization.

[–]ZoraksGirlfriend 88 points89 points  (9 children)

This is the correct answer. All methods of birth control for women are 100% covered by the ACA. You should only be paying the copay for the office visit.

[–]CausticMoose 14 points15 points  (0 children)

It's weird. I have copays for qll my doctors visits, including OB/GYN, but any appointment I had relating to my IUD (blood work, ultrasounds, insertion, discussion, check-ups) had no copay. It may just be my plan, but I had assumed since it was relating to birth control, the copay was included in the ACA coverage

[–]SquantoJonesIV 14 points15 points  (2 children)

Interesting. I knew about this but hadn't thought about or wondered whether male contraception or sterilization would be included. It's not.

[–]bguy74 2528 points2529 points  (330 children)

The rationale is fairly straightforward. If a women gets pregnant, that is a health issue for the woman - the insured person is the person's whose health is protected. When you get a vasectomy as the insured person, your health is not protected. It's 100% risk (procedure) and no prevention (for the insured party).

The insurance company incurs no obligation for health costs of the person you make pregnant, just of the insured themselves.

Edit: Yes, I typo'd women instead of woman. SORRY! And...no, you haven't educated me on what is proper. Holy crap people love to pounce.

[–]AdvancedGolem 259 points260 points  (160 children)

Interesting. Are there insurance plans for married couples that may cover a vasectomy then?

[–]trixtopherduke 147 points148 points  (152 children)

That's a family plan and they increase the amount you owe and what's covered can be the same as an individual plan.

[–]errorsniper 324 points325 points  (146 children)

Which is fancy talk for we will always set up any situation to be financially beneficial to us and fuck you anyway we can.

[–]aKnightWh0SaysNi 47 points48 points  (40 children)

They’re a for-profit business, what do you expect?

[–]Dangerpaladin 90 points91 points  (38 children)

Honestly? That our healthcare system isn't run for profit. It's kind of disgusting when you think about it.

[–]smokesinquantity 29 points30 points  (17 children)

My favorite logic against this is the people who cry out "well how do you expect people to still want to be doctors if they don't get paid as much"

As if the pharmaceutical industry and hospital administrative boards are also not bloating things so heavily.

[–]ExpiredOTMCalls 11 points12 points  (5 children)

Also, by making school cheaper! I would have gladly accepted a massive pay cut if I didn't start with 300k in student loans from med school.

Subsidize med school as a part of medicare for all and the physicians will likely complain a lot less.

Source: am a physician

[–]Neosovereign 2 points3 points  (1 child)

It is gonna suck if they simply cut my pay though when I still have this 300k sitting here though.

[–]rediraim 5 points6 points  (0 children)

As far as I know, the one candidate who unabashedly champions Medicare for All also happens to support eliminating all student loan debt ;-)

[–]gromwell_grouse 1 point2 points  (1 child)

Out of curiosity, how long did it take you to pay back that 300K? Be honest now.

[–]NoMenLikeMe 16 points17 points  (4 children)

Doctors definitely still do well in other countries.

They’re not making AS much, but they’re still clearing six figures in comparable countries like the Netherlands, UK, AUS, Denmark, Switzerland, and France.

[–]ambulancePilot 13 points14 points  (2 children)

It's only American doctors who feel this way. Doctors in other countries are not so moved by money because it doesn't cost a generational amount of money to become a doctor in the first place. The American system is rotten to the core, and these are all just side effects. When you make money the be all, end all, these are the types of things that occur given enough time.

[–]CoronaMcFarm 3 points4 points  (0 children)

Still doing six figures without ruining your economy for the rest of your life if you get sick

[–]Vishnej 2 points3 points  (0 children)

We have a crippling shortage of doctors and medical providers in general, which is why pay is high. We have this crippling shortage because Congress and the AMA (which represents existing doctors) wants a crippling shortage, so that doctor pay is high. So they framed a system in law which requires you to go through a long degree program and then medical residency at a hospital to be a doctor, and then they dramatically limited funding for medical residency programs. We just decided not to train new doctors at a rate commensurate with need.

This results in things like medical residents being overworked to the point that a "Campaign to reduce the workweek to 80 hours/wk" is an active source of discussion. It results in things like the highest suicide rate of any major profession. It results in loads and loads of dead or preventably ill patients, because severely sleep-deprived humans exhibit many of the same issues with cognition and memory that drunk humans do.

And it's resulting in a lot of places writing laws that permit them to reduce their reliance on "Doctors" in favor of "Registered Nurses" or "Physician's Assistants".

[–]SonOfTK421 1 point2 points  (0 children)

Don't you love it when people complain that doctors aren't paid enough? They compare them to athletes and entertainers and bitch that what doctors make should be so much more in comparison to the athletes and entertainers.

I'm sorry, what? There are over a million doctors in the US. There are over a million lawyers in the US. They all do just fine. There are fewer than 50,000 actors in the US, and far fewer of those are A-list, millionaire celebrities. Athletes are even rarer. Maybe 5000 professionals in the US.

Maybe I'm just weird, but I think it seems to be way harder to be an actor, and even more difficult to be an athlete, than a doctor or lawyer, and they are therefore compensated appropriately.

I think we can all agree, however, that the slobs running those industries are the real garbage who use and abuse people for money.

[–]kn33 22 points23 points  (2 children)

I've always thought it was disgusting, ever since I was old enough to think about it. Imagine how shocked and confused little /u/kn33 was when he learned that you had to pay for medical care when not having it meant you would go sick or die.

[–]Hamms_Sandwich 5 points6 points  (1 child)

i spent way too long trying to figure out who u/kn33 was

[–]aKnightWh0SaysNi 4 points5 points  (2 children)

I’m not saying one way or another whether it SHOULD be managed by profit-driven entities, just saying it’s a bit delusional to expect insurers to act in your interest under the current schema.

[–]Dangerpaladin 5 points6 points  (0 children)

I was answering the what do you expect question though. I expect that someone along the way would have said, Wait a minute this is pretty fucked up.

[–]the_rickiest_rick 1 point2 points  (4 children)

Then you’ll have start moving this toward political diatribe.

[–]Warpedme 6 points7 points  (2 children)

I think you mean an ethical diatribe.

[–]jimbojangles1987 5 points6 points  (1 child)

Don't you bring ethics into my capitalism!

[–]Dangerpaladin 3 points4 points  (0 children)

Meh, everything is inherently political its unavoidable.

[–]StonedOscars 0 points1 point  (5 children)

Oh gosh, you communist. /s

Forgive me for not letting the free market decide my healthcare.

[–]Lurker_81 7 points8 points  (1 child)

If it was a free market, it would probably be a lot better. Instead, it's an incredibly corrupt, politically-sanctioned cabal.

[–]Brichess 2 points3 points  (2 children)

I love having the lowest bidder who is best at extracting my money be my healthcare provider

[–]V1k1ng1990 4 points5 points  (0 children)

To be fair government often picks the lowest bidder as well. Single payer won’t make the care any better. What it will fix is people not getting preventative care and hopefully serious illnesses are caught sooner

[–]My_Butt_Itches_24_7 30 points31 points  (98 children)

My old man used to sell insurance. He told me that less than 0.1% of the money that is collected in premiums is paid out in claims. It seems like running a train on the average joe, really. This is why I am a huge supporter of having something like an HSA, but it's just a savings account and we get rid of insurance companies. All medical expenses can come from that account. The only logistical problem is that it would have to be run by the government and we all know how well the government handles money. Not to mention how great the VA can be.

[–]tomrlutong 181 points182 points  (41 children)

Under Obamacare, insurance companies must pay out at least 80-85% of premiums. Those that pay out less must return the excess to their customers. This applies to all health insurance, not just plans purchased through the exchanges. Source

[–]Ambadastor 90 points91 points  (25 children)

My friend, who is on an Obamacare plan, just received a check for $17 because the insurance company didn't hit the 80% by like 0.5%.

[–]neveraskedyou 28 points29 points  (24 children)

What does "having an Obamacare plan" mean? There isn't a public option under the ACA. It's a series of regulations applicable to all insurance plans.

Not being rude. I just see people talk about how some people have an Obamacare plan it they're mad they were forced to get an Obamacare plan but as far as I understand it there is no such thing.

[–]nighthawk_md 36 points37 points  (7 children)

They probably signed up as an individual on the healthcare.gov website.

[–]neveraskedyou 5 points6 points  (6 children)

Yeah, but that's not a special Obamacare insurance. That's just the method used to sign up for insurance.

[–]Herbicidal_Maniac 29 points30 points  (1 child)

There is no public option in the US. If you're very poor, you qualify for Medicaid. People are mad at Obamacare because for profit healthcare is a nightmarishly brutal system and Obamacare forces people to participate in it. Americans like to get mad at the symptoms and not the real problems.

[–]lionheart4life 4 points5 points  (0 children)

Those are the same people who will go to the hospital for a cold and get mad when they have an $800 bill. Or a real emergency with a $15000 bill that would have been covered under their $3000 Obamacare plan.

[–]most-likely-a-bot 3 points4 points  (1 child)

All plans in the US must now adhere to the rules of the ACA (“Obamacare”). Currently “having an Obamacare plan” and “having health insurance” mean the same thing in the United States.

If people are mad that they were “forced to get an Obamacare plan,” either:

1) they did not have health insurance at all before the ACA, and got health insurance solely to avoid the penalties for not having insurance

2) they were previously on a plan that was not ACA-compliant for whatever reason, and had to change to an ACA compliant plan

Some people refer to the individual plans offered on the health care exchange websites as “Obamacare plans” but calling them that is actually kind of meaningless, because all health insurance in the US must comply with ACA regulations.

Also, regarding the refund check the other poster mentioned: All insurers, not just the ones on the exchange, must refund premiums if they don’t meet the 80% rule. But for employer-sponsored plans, they send the refund check to the employer, and it is up to the employer whether to keep the refund or distribute it among the employees. I would imagine that most employers do not distribute the refunds.

[–]theriseofma-ma 7 points8 points  (1 child)

The regulations actually don't apply to all insurance plans. Remember when Obama said "and if you like your current plan, you can keep it"? That translated into having grandfathered pre-ACA plans. These plans still had to meet certain requirements, but not like the ACA plans. After March 2010, you couldn't purchase a pre-ACA plan as new. But if you had purchased it before March 2010, you could continue to renew into the plan until the "Keep Your Plan" program expired (to my knowledge it was renewed again for 2020).

Source: healthy actuary

[–]twotall88 3 points4 points  (0 children)

Until 2019 tax year you were required to have "A" health plan or face tax penalties:

Under Obamacare, most people must have health insurance or pay a tax
penalty. For 2017, the penalty is $695 per adult (up to a family maximum
of $2,085), or 2.5% of household income, whichever is greater. The
penalty for children is half the adult rate ($347.50).

So, say you have a family of 4 (pretty average, Mom/Dad and 2 kids even though the USA wide average person per household is 2.6). They would be liable to pay a tax penalty of $2,085 on top of the taxes they already owed for 2018 taxes. To avoid that they often bought a cheap plan though healthcare.gov (crappy plans that cost you money but don't really cover anything beyond catastrophic stuff).

So yes, there are Obamacare health plans colloquially known as that.

[–]gltovar 12 points13 points  (16 children)

I don't get your comment. If you got rid of insurance for an HSA, what happens if some one that is, for example, 20 has been working full time for a year and suddenly needs to have their appendix out? Cancer diagnosis? I am not justifying the current state of US insurance but I want to understand your perspective better.

[–]tionanny 16 points17 points  (4 children)

HSA is just another way for rich people to avoid taxes. The idea that most people can just spare extra money is delusional

[–]cerberus698 4 points5 points  (0 children)

A severe asthma patient who worked a low income job would have their HSA wiped out every single month.

[–]standard_candles 4 points5 points  (0 children)

Yeah I'm told all the time that I should save money by switching to a PPO plan with an HSA. That means I need to have thousands of dollars up front before I'll be able to enjoy the savings.

[–]halftanfish 14 points15 points  (0 children)


Your old man is wrong if he thinks that 0.1% figure is true. Just go look at the financials of any large insurer and you will see this. Like every other public company, they have to publish their financials yearly. I just checked my insurer and they spent just under 90% of the premiums on paying claims, and most of the rest on administration expenses.


This is a terrible idea and is generally called "self-insurance". What would you do if your "something like an HSA" doesn't have enough money to cover something uncommon and catastrophic like getting cancer at 23 or a huge car accident?

[–]Kurgon_999 4 points5 points  (0 children)

Are you talking about a collective account? Like paying taxes and everyone gets healthcare?

Or are you talking about a personal savings account? Because when you see insurance pay out 5 million usd for cancer treatment for a 36 year old, you start to wonder how she was supposed to save that 5 million.

[–]JerseySommer[🍰] 12 points13 points  (4 children)

That still only benefits the wealthy and screws the poor. I make $15/hour and work full time. My insurance is $100/month, after bills are paid I have about $100 left over. So even putting my insurance premiums and entire disposable income in an HSA would limit me to $2400/year. My EpiPen is around $800 retail, and my migraine medication is $300 for 6 pills. So before any illness or routine care [a LEEP procedure for a woman with HPV is $900, every 2 years to stave off cancer. ] I'm at $2000 just for medication alone!

[–]My_Butt_Itches_24_7 5 points6 points  (2 children)

The point of getting rid of insurances companies is to remove price gouging from pharmaceutical companies. They will have to lower pricing to be able to sell their products. Epipens don't cost anywhere near $800 to make and they sell them for that because of the insurance.

[–]twitchypixie 11 points12 points  (0 children)

They're still going to pick the highest price they think people are willing to pay and unfortunately for life saving medicine people don't have much choice. They don't care if the poor die or run themselves into unpayable debt.

Regulation is the only way to help prevent companies from taking advantage of people. Look up the radium girls or any of the other ridiculous horrible things companies have knowingly done.

[–]mosstrich 10 points11 points  (0 children)

How about healthcare being a right, and it just comes from taxes (like most other developed places). That way if two people in the same family got cancer, they wouldn't have to worry about maybe needing to pick who gets treated.

[–]millhouse412 1 point2 points  (0 children)

CVS has a generic EpiPen that cost me 85 bucks.

[–]tomoldbury 28 points29 points  (10 children)

It's not 0.1%. It's probably somewhere around 30 - 50%. That's still a huge skim off the top.

If you compare similar countries, i.e. US and Canada, then the Americans spend about twice as much per person on their healthcare.

The insurance companies can play a part in selling private healthcare to people who want it, but a public single payer option should be the standard, like the NHS.

[–]Flocculencio[🍰] 7 points8 points  (0 children)

You can do this even without single payer. Any public healthcare system properly leveraged can make private insurance work for its bread.

I'm from Singapore so I'll use us as an example. Like most universal healthcare systems, ours isn't an absolute state monopoly. We have compulsory insurance programmes that are partially government subsidised with the rest of the premium paid for through a Medisave account garnished from everyone's wages and in addition offer the option for people to purchase private insurance. This in practice means that private providers have to be competitive and provide value above and beyond the govt system to make their services worthwhile.

For example here in Singapore if I wanted to get the worrying mole on my back checked out I'd have three options:

A) Go through the public healthcare system This would be highly subsidised- I'd go to a government clinic to see a GP and request a referral to a dermatologist. The GP would do an initial triage and the clinic would make an appointment with the dermatology department of a public hospital. This would cost about $15 for the consultation. I'd have to wait a couple of hours to see the GP for the initial consultation and after referral, depending on the urgency of the condition I might have to wait a few weeks for the specialist consultation. Once I've seen the dermatologist, my specialist consultation and treatment would be heavily subsidized. My private insurance would also kick in here- depending on the plan I pay for I'd be able to choose a specific doctor instead of sticking with the one I was assigned, get a nicer ward and more coverage for treatment (but treatment would be subsidised nonetheless- insurance would apply on top of the government subsidies).

B) Go to a public hospital as a private patient Instead of going through the GP at the government clinic, I just go to a private GP and get a referral. This would cost about $50 for the consultation. Going to the public hospital, I'd have to pay more for consultation fees as I'm coming in as a private patient (as above my insurance could cover this depending on my chosen plan). I'd still be eligible for subsidies on my treatment though not as much as if I'd gone fully public. As you can see we aren't a single payer system- coverage is through a compulsory personal medical savings account, regulated insurance and public subsidy.

C) Go fully private. Go straight to a specialist. Pay for the privilege. Go to a private hospital for the treatment. Pay for the privilege (and a quirk of the system here is that the private hospitals usually have far less comprehensive facilities than the public ones- and many of these private specialists also practice part time in the public hospitals). Mostly only people who really want to see a specific superspecialist, want elective surgery which wouldn't be subsidised anyway, or non citizens who aren't eligible for subsidies go this route. You will probably need extensive and expensive insurance to cover this

It's more complex because we haven't got into means testing which gives you further subsidies in the public system but you get the idea. I also haven't listed some of the drawbacks of our system (basically if you fall into a sandwich class where means testing on subsidies can screw you over you can be in for a bad time but this is still nowhere near the horrorshow that the US healthcare system is).

Now the thing about this blended public/private system is that private insurance is (1) heavily regulated- they can't play fast and loose with their coverage plans especially when dealing with public healthcare and (2) have to be competitive because they need to justify their customers sticking with them just to have option C.

Universal healthcare provides a public baseline and encourages private competition.

My premiums for private insurance coverage involved in this are about $600 annually (this is what allows me to be hospitalised in a fancier ward than the basic subsidised tier plus covering things like choosing a specific doctor etc). On top of that I choose to have a rider which gives me access to various other services (eg no deductibles or copays) which costs another $500-something annually.

(All prices above are in Singapore dollars- one USD is approx 1.3 SGD)

[–]My_Butt_Itches_24_7 11 points12 points  (8 children)

The way I see it, it's the process that the insurance companies use to negotiate payment that has driven the sticker cost of healthcare through the roof. When doctors and hospitals charge huge amounts of money so that they don't undercharge themselves is a problem. When healthcare costs aren't driven by what the working man can afford, the working man will become dependant on the industry that sets the price.

[–]oskarfury 16 points17 points  (7 children)

There should be no middlemen in Healthcare.

Basic healthcare should be a right.

A UK citizen pays less per capita for healthcare than a US citizen.

[–]tomoldbury 15 points16 points  (2 children)

In the UK we pay about half as much and our outcomes are generally better too.

[–]wizzwizz4 4 points5 points  (0 children)

And that's even with the NHS going to shit.

[–]Fight_the_bastards 1 point2 points  (0 children)

Yes, but here in America, both the rich and the poor are equally able to die of easily preventable diseases that they can't afford to go to the doctor for, so we don't have none of that socialism crap!

Also, all of my insurance premiums go into a special account that's only for me, because that's how insurance has always worked, because there's no way that I should be forced to pay for anyone else's care, and even though I made that up and that isn't how it works at all, people still feel like it is, and feelings are more important than facts in trump's America.

[–]computerarchitect 2 points3 points  (2 children)

Ok, but what about all the investments in bonds that they make? Premiums are only part of the story...

[–]halftanfish 6 points7 points  (1 child)


That is where a lot of the profit is actually made. The guy you are responding to is full of shit (but reddit loves hating on insurance, so he will be upvoted anyway). Most insurance companies spend almost all of the premiums on a combination of claims and administration costs of paying those claims / collecting premiums

[–]computerarchitect 1 point2 points  (0 children)

That makes much more sense. Thanks.

[–]Nope_______ 2 points3 points  (0 children)

Well, your old man was wrong, sad to say. Or intentionally misleading you.

[–]arnoldrew 3 points4 points  (1 child)

He’s strictly, factually wrong. Some insurance companies actually pay out more than they take in in premiums and make money by investing the large amount of cash they have on hand.

[–]paul-arized 2 points3 points  (0 children)

And they used to cap it (lifetime limit) so say if your or your child's cancer treatment already incurred 1 million dollars, they won't pay out anymore. (This is in the USA.) So Obamacare really helped to do two things that were extremely important: prevent insurers from not insuring patients who had what they consider preexisting conditions (like if you suffered from acne as a kid and then had cancer but they claim one cause the other or such bs), and also remove lifetime coverage limits, assuming the insured met the deductibles for their plan (assuming there is a deductible for that plan).

[–]MINIMAN10001 2 points3 points  (4 children)

I have someone at work who has an HSA plan leaving her thousands in debt that is currently being garnished against her at an amount that exceeds her left over cash after bills are paid with thousands pending transfer to collections. This would have been avoided with insurance. That's the whole point of insurance is there isn't really any upper limit to how much hospitals will charge you. With insurance, there is an upper limit.

[–]card85 0 points1 point  (0 children)

Not gonna lie, totally read your username as errorsnipper. Your comment makes sense then and now...

[–]mattvait 1 point2 points  (1 child)

Coverage doesnt change family plan or individual. Just family has higher deductible

[–]jimbojangles1987 1 point2 points  (0 children)

Lol that's fucking stupid

[–]lodelljax 9 points10 points  (1 child)

Yes. Sort of. The military healthcare, which is not really insurance but close enough, does pay for your vasectomy. However in the USA military system also covers your family so they have a motivation to prevent kore pregnancies.

[–]ThrowMeAwy1996 3 points4 points  (0 children)

If you have insurance through your employer the coverage can vary based on what the employer decides to add or pay extra for. I do see plans that cover a vasectomy at 100%.

Source, am insurance - beep bopp -

[–]buzzingbuzz 1 point2 points  (0 children)

They don’t GAF if you’re married. I got one 6 years ago. I called them upon finding out I had to pay for the vasectomy out of pocket. They will gladly pay for my wife to have as many babies as we wanted at $12k each time but wouldn’t cover any part of a $600 vasectomy.

[–]themapoe 186 points187 points  (27 children)

Fun fact: This is also why we haven't been able to figure out male birth control. First and foremost, the process of stopping sperm production in a temporary way is difficult. Secondly, the side effects are always a trade off. With hormonal birth control, there are a ton of negative things that can happen. For most people, these are not life threatning but are very annoying (weight gain, acne, depression). Us lady folks put up with it because the alternative is pregnancy and mild weight gain is not worse than carrying an unwanted pregnancy. From a strictly medicial stand point, pregnancy is dangerous, so the side effects of birth control are worth it as they are necessary to prevent something significantly worse.

With men, there is nothing significantly worse to prevent. Therefore, even if a male birth control pill has the exact same side effects as the female version, it is medically unacceptable because there is no risk to the male if he stops taking it. Again, from a strictly medical stand point, the desire to independently control when/how you reproduce is not relevant. Even with female birth control, the main point is not preventing a baby but preventing a pregnancy. For male birth control to be approved, it would have to have virtually no side effects, and this is not super realistic.

Think of it this way: Cancer will kill you, so it is okay that chemo has such bad side effects. It would not be okay for, say, headache medicine to have these same side effects because having a headache will not kill you.

[–]iamagainstit 18 points19 points  (0 children)

Similar to why the HPV vaccine was only approved for women at first.

[–]sonofeevil 18 points19 points  (0 children)

Also female birth control is mimicking a hormonal state that already exists which prevents pregnancy.

At no point do males stop producing sperm whicheans there's no "sterile" state we can replicate like in women.

[–]DogIsMyShepherd 36 points37 points  (6 children)

Good point about the side effects and severity risk/benefit ratio. Although if you suffer from migraines, you might feel like it's going to kill you.

Also, migraine medicines do sometimes have hella terrible side effects to them.

[–]themapoe 8 points9 points  (0 children)


Of for sure. I'm biased because I've only ever had tension headaches that go away if I take a nap, so I was thinking along the lines of Advil. But yeah, from how people have described migraines, I feel very lucky.

[–]polar2292 1 point2 points  (4 children)

Are you getting migraines because of the OCP you're on or during the 'off week'? A lot of migraines in women associated with OCPs tend to be estrogen receptor related and can be decreased by switching to different pills or skipping the last week.

[–]twitchypixie 4 points5 points  (0 children)

Taking the pill continuously is the best choice I ever made (except maybe my bi scalp). But omg if I fuck it up... had a really bad week and somehow missed three days, the migraine and everything else, kill me now xx

[–]DogIsMyShepherd 1 point2 points  (2 children)

I'm not a woman, so this threw me off for a second lol, I couldn't figure out what OCP was referring to for a second.

I'm just unlucky I think. I started getting migraines in the second grade. At this point my head has been MRI'd and Catscanned enough for a lifetime and I'm still only fairly confident it's not a brain tumor waiting to kill me, but between the migraines and the occasional break through seizure amongst other things, I'll be on some sort of medication for the rest of my life.

[–]Landorus-T_But_Fast 14 points15 points  (2 children)

A lot of birth control was developed in the 1960s and 70s with second wave feminism making rounds. When birth control became a method for female empowerment, getting it into the market was as much political as medical, so regulators and the manufacturers faced strong pressures to get them on the shelves.

[–]sorrylilsis 14 points15 points  (0 children)


So many people have no damn idea what a benfit/risk ratio is and spout bullshit about male contraception...

[–]itssomeone 4 points5 points  (0 children)

This is why vas-occlusive blockers are the most likely to hit the market first I reckon.

[–]spaceefficient 3 points4 points  (1 child)

That, but also one of the trials for male birth control was stopped because it was causing infertility in some cases and then was reported on as though it was just the standard hormonal types of side effects.

[–]themapoe 1 point2 points  (0 children)

Yes this is true. It's BS that the headline was "Male Birth Control Trials Stopped Because Men Faced Weight Gain and Mood Swings."

[–]RalphieRaccoon 10 points11 points  (5 children)

I heard the side effects were actually quite severe in some cases, which was why some trials were stopped. I think the depression could be quite bad, to the point where they feared some were a suicide risk.

[–]neveraskedyou 44 points45 points  (3 children)

That's true of hormonal birth control for women as well

[–]gee7894 22 points23 points  (22 children)

Out of curiosity then is women’s health insurance more expensive than men’s? (Because of the potential health issues and procedures that go with getting pregnant?)

I’m from the UK so have no idea how your health insurance works

[–]Daripuff 35 points36 points  (17 children)

I'm pretty sure it used to be, but that got shot down in a discrimination lawsuit by the ACA, so they just raised the price on both men's and women's to cover the extra expenses that a woman will statistically incur.

[–]Deleriumb32 44 points45 points  (3 children)

It was not a lawsuit that stopped it, but the ACA, aka Obamacare.

[–]MazzIsNoMore 20 points21 points  (1 child)

This is correct and was a big point in the push for the ACA.

[–]The_Power_Of_Three 2 points3 points  (0 children)

And a big point in the pushback against it, among those who oppose it.

[–]paul-arized 6 points7 points  (5 children)

Smokers pay more for life insurance, but for health insurance they pay the same as non-smokers, who subsidize the smokers medical treatments and raising premiums for everyone. (Yes, premiums subsidize everybody else's treatment, and healthy people subsidized sick or injured people's bills.)

[–]Moccus 6 points7 points  (4 children)

The ACA allows a tobacco surcharge on health insurance premiums. Smokers at my office pay roughly 50% more than non-smokers for the plan I have.

[–]hey_tc 4 points5 points  (6 children)

Ha, the opposite of when they decided women getting cheaper car insurance was discrimination...

[–]Nope_______ 10 points11 points  (5 children)

The EU considers that a violation of human rights. Maybe one day the US will figure it out too.

[–]-Decimus- 5 points6 points  (3 children)

We have a human right to car insurance?

[–]The_Power_Of_Three 2 points3 points  (0 children)

You have a human right to be free from systemic sex discrimination.

[–]Prosthemadera 1 point2 points  (0 children)

I don't know about human rights but car insurance is compulsory in the EU.

[–]LonestarTarheel 2 points3 points  (0 children)

It is slightly more expensive for women in their twenties than for men of the same age range specifically because of pregnancy related costs. Insurance slowly becomes more expensive for men as they get older. This applies to individuals who are paying for their insurance themselves and not part of an employer group plan which will have all participants paying the same rate.

[–]manute-bols-cock 2 points3 points  (0 children)

Women from 18-44 are more expensive than men to cover, but men 45+ (especially 65+) are much more expensive than women of the same age. It all kind of evens out over time

[–]Excludos 8 points9 points  (0 children)

Don't live in the US so I can't claim I know, but I would guess probably not. Men have other health issues that can crop up, and are statistically more likely to get hurt/hurt themselves than women.

[–]Mikisstuff 1 point2 points  (0 children)

It costs extra in Australia - but its an 'optional extra' so you choose to add pregnancy coverage to your insurance if you want it. So either a woman chooses to pay it to enter the private system or she defaults to the public health system regardless of her other coverage.

[–]BloodBaneBoneBreaker 52 points53 points  (0 children)

Wow. Not sure how true this answer is, but it sure makes sense. I dont care if it's the reason or not. It's good enough for me. Great explanation.

[–]-give-me-my-wings- 10 points11 points  (9 children)

My dad got his insurer to cover his vasectomy in the 80s by talking to them and asking why they would be okay for paying for a whole new human being for 18 years but not paying for his vasectomy.

He absolutely had a point, too. Even if the woman isn't on the policy, as soon as the baby is born, that child is highly likely to be added to the policy no matter if the man and woman are even in a relationship.

[–]KernelTaint 3 points4 points  (1 child)

Wouldn't adding that child to the policy increase the policy costs? And if so that cost increase is a calculation that covers the child (averagely speaking.. otherwise they'd never make money).

[–]MunchieCrunchy 2 points3 points  (0 children)

Yup, it's different if you're a woman however because being pregnant has a lot of health risks in and of itself. So to them the cost of paying for the surgery can outweigh the cost of potential future pregnancies.

[–]SallyMRide 5 points6 points  (0 children)

Wow, this isn't something I can say I've ever thought about but turned out to be really interesting.

[–]daeronryuujin 6 points7 points  (4 children)

Bingo. Preventing pregnancy saves the insurer a lot of money in the long run, but that's on the female side.

[–]CarnivorousCircle 0 points1 point  (3 children)

If it’s a family plan (which it is in most cases) does that really make sense?

[–]daeronryuujin 1 point2 points  (0 children)

Not as much, but in that case the mother is one of the insured on that plan.

[–]Whatchamacallit90[S] 36 points37 points  (16 children)

Well they do incur the cost/obligation of the woman I make pregnant as we're on the same policy, but I do see what you're saying. Especially in the case of a single Male on his own policy.

[–]DonnyWhoLovesBowling 102 points103 points  (13 children)

Yes however, if you got a vasectomy... the woman on the policy can still get pregnant. Not saying she will or that it’s likely, but from an insurance companies point of view it’s still possible.

[–]crabbytag 16 points17 points  (8 children)

Also, OP might make a different woman pregnant, one who isn’t on the policy.

[–]kyoto_kinnuku 5 points6 points  (7 children)

Difficult after a vasectomy.

[–]HelpfulAddendum 3 points4 points  (0 children)

So there's a chance!

[–]paul-arized 2 points3 points  (5 children)

Only after a certain period has passed (a few weeks) and only after a doctor verifies after that period of time the procedure was effective and done correctly. Even after that there is still a 0.1 to 0.2% chance.


[–]iKoya 6 points7 points  (4 children)

Can confirm that there is still a chance of pregnancy after a vasectomy. Boyfriend was cleared and procedure was done correctly, but we still fell within that 0.1-0.2% chance (currently 15 weeks pregnant).

[–]paul-arized 2 points3 points  (3 children)

I mean to pry, but you can refuse to answer, but did he get it done so that he can stop wearing condoms or so that you could stop taking the pill, assuming you did/do?

[–]iKoya 1 point2 points  (2 children)

He got it done long before we started dating, before he got divorced actually. We obviously assumed wrong that it would be safe to go ahead without any sort of additional protection. I've personally never been on birth control even with my ex of 14 years (we accepted the risks and did "natural family planning").

[–]paul-arized 1 point2 points  (1 child)

Wow, life is so unpredictable! And thanks for sharing.

[–]centurion236 14 points15 points  (1 child)

Possible, but much less likely. It definitely reduces the financial risk for the insurer. Also, if the woman gets pregnant after the man gets a vasectomy, they might not stay on the same insurance very long...

[–]CarnivorousCircle 1 point2 points  (1 child)

Actuary here, though not in health insurance. Sure it’s still possible but it’s far lass likely so I don’t buy this reasoning.

[–]Kammander-Kim 10 points11 points  (0 children)

You can make another woman pregnant. Not just your spouse. And your spouse can become pregnant by Another man.

Snipping her stops the health risk of her pregnancy for the involved parties. Snipping you does not stop her from getting pregnant.

Monogamy and fidelity is not really a thing when it comes to health insurance in this case.

[–]Ani_Infijar 1 point2 points  (0 children)

Also, it can possibly reduce ovarian cancer risks!

[–]SeniorZoggy 2 points3 points  (13 children)

So is it considered preventative treatment for a woman but not for the man?

[–]bonreu 50 points51 points  (9 children)

The man cant die in child birth. Well he can but that's called murder. The insurance is only for the insured person, no one else, regardless of them being family or otherwise.

[–]ZippyDan 9 points10 points  (0 children)

The man cant die in child birth.

Hold my beer

[–]Landorus-T_But_Fast 3 points4 points  (0 children)

Actually, if a man dies during childbirth it's called a "miscarriage."

[–]SurprisedPotato 3 points4 points  (1 child)

I heard of a husband who, witnessing his child's birth, fainted, knocked his head on a table, and wound up in ICU

[–]Whitrian 1 point2 points  (0 children)

Kind of like trying to account for the risk of getting into a car accident when the father is trying to rush to the hospital because his son is being born.

A lot of things can always happen but they are kind of beyond the scope of what insurance company is interested in calculating for a personal health insurance

[–]cyclonewolf 24 points25 points  (0 children)

Pregnancy comes with alot of risks on top of pre and post natal care. There are complications that can arise, or death. Pregnancy is alot of work and it's hazardous to her health. Insurance would see this as a liability, and so can perform the surgery to prevent this. Nothing will happen to the man if he does not get a vasectomy and continues to have sex (obviously there are special cases, but this is very general). So yes, it's preventative treatment for women and not men. This is the case for a lot of things, and visversa.

Not saying I agree, I think vasectomies should be covered, just as I think tubal litigation should be. However, there is a signifigant difference in reasoning and priority.

[–]RooftopBBQ 3 points4 points  (0 children)

of course, since a man doesn't get pregnant there's nothing to prevent. He can get someone else pregnant, but other people are outside the scope of health insurance, which only applies to the insured person.

[–]mub 0 points1 point  (2 children)

So can a woman use her insurance that get her boyfriend or husband a vasectomy?

[–]therankin 0 points1 point  (0 children)

Wow, I've honestly never thought about it that way.

Thank you for enlightening me just a little bit this morning.

[–]72057294629396501 0 points1 point  (0 children)

Would it be covered if the wife is also under the same health plan? Since the wife will be most likely became pregnant?

[–]kirstimont 48 points49 points  (0 children)

The ACA requires that tubal ligations be 100% covered, as it is preventative care in the form of permanent birth control. I don't believe that vasectomies need to be covered under the ACA. Your insurance is likely doing the bare minimum requirements in order to meet ACA standards.

[–]majorboredom1 267 points268 points  (21 children)

Also, your plan is skewed on this one. My husband's vasectomy was far cheaper than my IUD insertion was, his costing next to nothing and mine costing hundreds.

American healthcare is essentially a shitty gameshow and we're all the losers.

[–]SoVerySleepy81 78 points79 points  (5 children)

Agreed. My husband's vasectomy was going to be $32 out of pocket. A tubal ligation for me was going to be a few thousand as we had a really high out of pocket maximum. Luckily? I ended up getting a c section with my last and they did the tubal while they were in there. OP has weird insurance.

[–]Trawrster 12 points13 points  (2 children)

If you're privately insured, it depends, but Medicaid specifically covers female contraception (including sterilization) but doesn't cover vasectomies.

[–]MunchieCrunchy 8 points9 points  (1 child)

IIRC the ACA made it mandatory for private insurers to cover female contraception.

[–]Panfryguy 2 points3 points  (0 children)

If it's 32 out of pocket it was mostly covered by insurance. That's not OPs situation

[–]powersoftyler 2 points3 points  (0 children)

I find that so funny for some reason. "Oh yeah we had ya open so we figured why not take out your appendix too just in case"

[–]girlikecupcake 10 points11 points  (1 child)

When was your IUD insertion? Mine was completely covered by my insurance as contraception when I had it replaced a few years ago, only had the copay for the office visit itself. The reasoning I was given was that they were required to cover birth control in general, but could give favoritism to generics.

[–]squrr1 36 points37 points  (1 child)

You get a bill! You get a bill! You get a second mortgage! You get a bankruptcy!

[–]Turbotroll 14 points15 points  (0 children)

I once was told a bill, got seen, got a bill 10x higher than I was told, complained over the phone, and then got a bill half the size of my original expectation, because reasons. Every other time I've gotten a second mortgage, because my coverage never seems to apply whenever I need it. Fuck our system.

[–]whileurup 5 points6 points  (5 children)

My brother just got sent home straight from ICU after a head injury and bleeding on the brain. This was decided by insurance. Not the hospital. He needs to be under professional care and that's not us, but we're trying our best. That was his second visit after an accident btw. So maddening!

[–]turk4lyfe 3 points4 points  (0 children)

Unless you are on a religious exemption plan your IUD and necessary insertion costs should have been covered at 100% if you saw a contracted provider. Extra costs like pain relief or labs your provider could have billed may not be covered at 100%, but if you had it inserted less than a year ago you should call your insurance and tell them you got it for pregnancy prevention and it is preventive healthcare and they need to pay it as such.

[–]caycan 5 points6 points  (0 children)

That sucks. I’m Canadian and my IUD implantation appointment was free (I get 80% drug coverage through my employer so I had to pay $40 for the IUD at the pharmacist). It’s the most cost effective birth control option and effective at preventing unwanted pregnancies....having to pay 100s for it is a damn shame.

[–]CausticMoose 3 points4 points  (0 children)

I tried to get an IUD a few years back, but couldn't afford the $800 for it since my insurance deemed it a "medical luxury", despite my doctor filing it as a necessity to help my cramps and heavy bleeding/clotting. It was $800 Fast forward 3 years, I got my IUD 3 months ago and everything was covered. It was crazy

[–]Robert_A_Bouie 169 points170 points  (13 children)

It's quite simple really.

You can't get pregnant.

Just because you get clipped doesn't mean that she can't.

If the insurance company's goal is to reduce claims by reducing the number of pregnancies, they'll do a much better job of that by paying for women to get their tubes tied than they will by paying for men to get clipped.

[–]blackirish74 94 points95 points  (12 children)

A common misconception is that health insurance is a "discount club" for medical issues.

It's INSURANCE. It's placing a bet. You're betting that you're going to spend more than X amount of dollars per month in healthcare costs.

X is your premium.

The Insurance company will see your bet but only if it makes sense for them to make money in the long run.

You getting a vasectomy is a lose for them since you can't get pregnant and by paying for the vasectomy they aren't preventing further cost to them.

Your wife can get pregnant regardless if you've had a vasectomy or not. So they'll cover the procedure that garauntees them a better return in the long run cause let's face it babies are expensive.

[–]Yeahnofucks 19 points20 points  (2 children)

Yep! Insurance is always a bet. Can look muddy when you look at health insurance but is clearer when you look at something like car insurance. If I’m a risky demographic - young, male for example, I pay more, same for if I have an expensive car that costs more to replace. You also have government regulations- in my country it’s illegal to base insurance decisions on gender, so ‘male’ might be a more risky demographic statistically speaking, but you can’t use it to calculate the odds. With health insurance you could compare this to pre-existing conditions, no insurer wants to cover this, but in some countries they’re forced to.

For the vasectomy the chance that you would get pregnant and incur further health costs is 0. However, some companies will cover it as insurance is purchased by employers, so when they employ someone insurance is a benefit they offer, and covering more procedures makes it a more attractive benefit.

[–]Black_Moons 12 points13 points  (1 child)

Maybe the one payer healthcare would get more traction if we legally force renamed 'health insurance' companies to 'Health Casinos'

[–]taleofbenji 2 points3 points  (3 children)

So my insurance company thinks my wife might be a dirty whore?

[–]PugWizardGaming 1 point2 points  (0 children)

more like they don't always cover the wife and as such they don't care, everything is calculated on an individual person basis

[–]N5tp4nts 0 points1 point  (0 children)

That’s true with all insurance except health insurance. At least in America.

[–]pyanan 4 points5 points  (0 children)

Insurance professional here. A lot of plans do cover sterilization procedures for both sexes. Mine covered my vasectomy. There was a $300 tray fee charged by the doc. That meant that the doc wasn't happy with the amount the plan would reimburse him for it. The reason a lot of plans cover them because it is cheaper than covering more pregnancies and children. As for why yours covers hers but not his...I suspect it has to do with the idea that if u prevent a woman from getting pregnant again, you know that your insured will not have any more children and will not have any more high risk pregnancies or emergency c sections. Whereas with a vasectomy it may just be harder to quantify the savings. There also could be a regulatory requirement. In Florida you can buy an individual health insurance plan that doesn't cover pregnancy. It's cheaper obviously. But if u end up having a high-risk birth or complicated delivery those plans have to kick in, because then it's an emergency and the state of Florida says they have to. So maybe your state treats tubal ligation as a medical procedure and says the insurance companies have to cover them. They are riskier and more invasive. Whereas vasectomy may be more of an electice thing. Just speculating...

[–]SprinklesOfFun 12 points13 points  (2 children)

A tubal litigation can be done for so many other reasons than just avoiding a pregnancy. A tubal litigation can literally save a woman’s life.

A vasectomy only has one purpose, and it’s to avoid impregnating someone.

Basically, tubal litigations are seen as a necessary surgeries (in some cases), and vasectomies are seen as “luxury” surgeries. Vasectomies are always a choice. Tubal litigations are sometimes to save the woman from debilitating health problems, some of which could even kill her.

[–]gogo-gadget69 3 points4 points  (0 children)

That is not really why it’s covered thou. Insurance doesn’t cover MANY procedures that might be life saving. They do have to cover certain things legally, however. Tubal ligation is one of them.

You make it sound like the insurance company cares about the individual’s actually health. They don’t. They care about the laws and what the individuals healthcare needs will cost.

[–]WriteBrainedJR 2 points3 points  (5 children)

Tubal saves your insurance company, on average, a shitload of money. If you get the snip, it doesn't save them dick unless you're married to a woman and she's on your plan.

[–]crazdtow 1 point2 points  (0 children)

Because tubal ligation is a surgery that you will spend the night-a vasectomy is considered an “outpatient” surgery which I know my insurance makes me meet the deductible first also.

[–]StrangestTwist 1 point2 points  (0 children)

This may have been covered but most of the comments were debating insurance costs and health issues and not a real answer. As somebody who works in insurance (don't shoot me, I know it's a shity industry) and sees this everyday, it does depend on the options that the employer chose to cover when picking the plan. Each option the employer chooses to cover increases the premium. There are also 3 types of funding they can choose from- fully funded, which is the insurance company fully paying your insurance claim according to your benefit plan and is 100% subject to federal guidelines; ASO, or employer funded, which is where the insurance company will administer your benefits as chosen by the employer but your claims are paid out of an account set aside by your employer. This is not subject to federal guidelines; the last is a hybrid funding plan where costs are shared by the employer saying they will pay up to a certain dollar amount and anything over that the insurance company will pay. It is governed by federal guidelines as well. Premiums for ASO are the lowest and highest for fully funded. Most employers choose ASO. Statistically, a man is more likely to get a vasectomy as it's cheaper, less invasive and easier to reverse. To be compliant with the ACA they have to cover one option. Most choose to cover the one they'll be least likely to have to pay out on. I hope this helps answer your question.