Does Medicaid Cover Circumcision In Florida


Circumcision Rates Lower In States Where Medicaid Does Not Cover Procedure

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University of California – Los Angeles
Hospitals in states where Medicaid does not pay for routine male circumcision are only about half as likely to perform the procedure, and this disparity could lead to an increased risk of HIV infection among lower-income children later in life.

Hospitals in states where Medicaid does not pay for routine male circumcision are only about half as likely to perform the procedure, and this disparity could lead to an increased risk of HIV infection among lower-income children later in life, according to a UCLA AIDS Institute study.

Researchers found that at hospitals in the 16 states where the procedure is not covered, circumcision rates were 24 percentage points lower than at hospitals in other states, with lower rates particularly prevalent among Hispanics. The mean male circumcision rate for all states was 55.9 percent.

The findings are important because they document the effect of state Medicaid reimbursement policies on the medical services that are actually delivered, said the study’s lead author, Arleen A. Leibowitz, a professor of public policy and a researcher with both the UCLA Center for HIV Identification, Prevention and Treatment Services and the UCLA AIDS Institute. These services include male circumcision, which has been shown to lead to substantial health benefits in later life.

Study co-authors were Katherine Desmond, M.S., and Thomas Belin, Ph.D, both with UCLA.

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State Limits Circumcision Coverage

Medicaid will no longer cover most of the surgeries in Florida as state officials seek to reduce costs.

TALLAHASSEE – Florida has taken sides in the long-running debate over the medical necessity of circumcision. It has joined the opposition.

Beginning today, the procedure is no longer covered by Medicaid in Florida except in limited cases.

That means a Medicaid mom who wants her newborn circumcised will have to find some other way to pay for it, while those with private health insurance will generally find the procedure is covered.

It’s a cost-saving step, lawmakers say.

“You have to spend Medicaid dollars on medically necessary services,” said Rep. Frank Farkas, a St. Petersburg Republican and vice chairman of the House Subcommittee on Health Appropriations. Research suggests circumcision is done more often for cultural or religious reasons, Farkas said. “It really was a no-brainer.”

The change is expected to save the state $2.3-million a year.

In the past four years, Medicaid paid $5.8-million for almost 45,000 circumcisions in Florida.

Medicaid will continue to cover the procedure in the case of injury or other problems.

But what was once routine procedure performed within days of a boy’s birth won’t be for the poor.

Medicaid has paid between $151.19 and $222.79 per circumcision, depending on the type of procedure used and whether there are complications.

“We wouldn’t use taxpayer dollars to pay for other cosmetic surgery,” Goldman said.

How Much Does Circumcision Cost

If youre curious about the cost of circumcision, examine the data below.

Circumcision Costs for Infants, Boys, and Adult Men


Compared to infants, circumcision for young boys and adult men could cost nearly $2,000. Although Medicare and Medicaid wont cover circumcision for young boys and adult men, a health insurance company may.

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Radiology And Nuclear Medicine Services

Does Medicaid Cover Circumcision In Florida

Services that include imaging such as x-rays, MRIs or CAT scans. They also include portable x-rays.


  • – Covered as medically necessary

COPAY: Waived per portable x-ray visit Waived per office visit

PRIOR AUTHORIZATION: Plan OK Needed for advanced imaging such as MRI or CAT scans. No Plan OK Needed for x-rays

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Is Circumcision Paid For

In the case of patients without health insurance, circumcision usually costs $150-$400 if their doctor is involved, and possibly an additional facility fee of about $75-150. More funds can be added by the facility fee of up to $150-200 for a newborn. A California based clinic in Northern California charges $150 for abortions performed after seven weeks of age.

Does Staywell Cover Circumcision In Florida

Newborn Circumcisions Staywell provides circumcision coverage for children up to 3 months.

How much does a circumcision cost for an infant?

The average hospital cost of a circumcision nationwide is about $2,000, according to the Department of Health and Human Services. However, many insurance plans treat the procedure as elective and thus wont cover it unless medically necessary. At UCLA, the list price for a circumcision is $1,205.

When is it too late to circumcise your baby?

But if parents choose this for their baby, the procedure is usually performed on the first or second day after birth in a healthy baby. However, it can be done within 10 days of birth. Circumcision is riskier and more complicated in infants older than 2 months of age, and in older boys and men.

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Top Rated Assisted Living Communities By City

Medicare doesnt cover the cost of personal care or room and board at an assisted living facility, however, it may be used to cover certain medical expenses a person incurs while they reside in such a facility. Seniors who are on a low income and would struggle to pay for assisted living may be eligible for state Medicaid programs that cover all or part of the associated costs.

Assisted living is a lifeline for many seniors who are unable to tend to their own personal care needs but dont require the full-time care and supervision provided in nursing facilities. The average cost of assisted living in the United States is $4,300 per month. This is almost three times the average monthly Social Security retirement benefit amount, which means many seniors need assistance from Medicare, Medicaid or other programs to cover the cost.

Helpful Resources

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No Aca Medicaid Eligibility Expansion In Florida

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Florida is one of 12 states that has not expanded Medicaid eligibility as allowed under Affordable Care Act . The ACA doesnt provide subsidies for people with income below the poverty level, because the law called for them to have Medicaid instead. But in states that have refused Medicaid expansion people who arent eligible for Medicaid and whose income is too low for exchange subsidies are in whats called the coverage gap.

Federal poverty level calculator

Floridas eligibility standards are:

  • Children up to 1 year old: 206% of the federal poverty level
  • Children ages 1-5: 140% of FPL
  • Children ages 6-18: 133% of FPL
  • Pregnant women: 191% of FPL
  • Adults with dependent children: 27% of FPL

People who qualify for Supplemental Security Income automatically qualify for Medicaid in Florida. See more information in the SSI-Related Programs Financial Eligibility Standards.

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ADvantage Waiver Program

The ADvantage Waiver Program may pay for memory care services for those in residential care communities licensed as assisted living facilities. Some services this waiver covers include:

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  • Physical, occupational and speech therapy
  • Transportation
  • Restorative and supportive services

To be eligible for services, applicants must be at least 65 years old or disabled, and they must reside in a Medicaid-approved memory care facility as an alternative to a nursing home. They must also meet financial eligibility requirements to qualify for SoonerCare.

Seniors can apply for this waiver by visiting their local Department of Human Services office and filling out an application in person. Alternatively, they can call the ADvantage Administration office at 435-4711. To establish eligibility, a nurse asks the applicant questions regarding their medical history, current needs and social activities.

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How do I comfort my baby after circumcision?

Does a circumcision hurt a baby?

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Florida Medicaids Covered Services And Hcbs Waivers

The list below provides direct links to a general overview for each of the covered services. For specific policy and limits information, please see the Medicaid coverage policies and fee schedules by visiting the

The Agency is committed to working with SMMC plans to promote continuity of and better access to care for Medicaid members. To better connect members to appropriate services, providers can visit the . Click on each health plans link to find information on Expanded Benefits, Discharge Planning Tools and other helpful resources.

Covered Services

Does Insurance Pay For Circumcision

peaceful parenting: December 2011

Routine circumcision for infants often is covered by insurance companies, though some consider it cosmetic. For example, Kaiser Permanente covers routine circumcision for newborns, but covers the procedure only when medically necessary — such as for recurring infections or cancer — for older children and adults.

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Does Medicaid Cover Circumcision In Florida : Where Are States Today Medicaid And Chip Eligibility / The Patient Must Be Competent To Make A Voluntary Decision About Whether To Undergo The Procedure Or Intervention

You cant use an hsa to pay health insurance premiums, and if dental and vision are included as part of your plan, rather The patient must be competent to make a voluntary decision about whether to undergo the procedure or intervention. 09.07.2020 · informed consent is the process in which a health care provider educates a patient about the risks, benefits, and alternatives of a given procedure or intervention. 27.09.2021 · in 2019, klepper was the host and executive producer of klepper, a comedic docuseries. By then, six mothers and babies had died and others had learned to live with catastrophic injuries.

Circumcisions In Older Boys And Related Costs Skyrocket In Florida Uf Health Study Shows

Category:Gender, Health, Research

GAINESVILLE, Fla. Circumcisions in Florida boys over the age of 1 have increased dramatically in recent years, doubling costs to the state, a study by University of Florida Health surgical researchers shows.

Dr. Saleem Islam, an associate professor in the College of Medicine department of surgerys division of pediatric surgery, said he and his study collaborators believe the states decision to terminate Medicaid funding for routine circumcisions in babies under 1 month old has led to the increase in circumcisions for older boys. The study was published in the September issue of the journal The American Surgeon.

Islam said families should decide for themselves whether to have their sons circumcised, but emphasized that circumcision in the newborn period is preferable for several important reasons.

The benefits are that the child does not have to undergo general anesthesia, there is much less cost to public monies, its safer for the kids to get it done and thats the right age, as well, he said.

Because newborns require only local anesthesia for a circumcision, newborn circumcisions are safer and much less expensive. They also have a lower risk of complications. Circumcising older boys requires general anesthesia to ensure the patient remains still during the procedure.

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Newborn Circumcision Shown To Be A Better Financial Choice In Medical Coverage

Physicians have debated for years whether to cut foreskin. Its unclear whether potential benefits of circumcisiongreater prevention of health problems such as urinary tract and HIV infections, STDs and penile canceroutweigh the risks of surgery.

Physicians have debated for years whether to cut foreskin. Its unclear whether potential benefits of circumcisiongreater prevention of health problems such as urinary tract and HIV infections, STDs and penile canceroutweigh the risks of surgery. Many parents adhere to national guidelines from the American Academy of Pediatrics , which in 1999 deemed circumcisions as medically unnecessary. Florida and 11 other state governments also followed AAPs stance when they decided to drop the procedure from Medicaid coverage.

These states, however, may have defeated their own cost-savings efforts, a Wall Street Journal reportnoted this week. A University of Florida Health studyshowed that between 2003 and 2008, a period just a few years after Florida stopped coverage, the number of older boys who required circumcisions rose sharply. Such surgeries often take place because of concerns about urinary-tract or penile infections, which are less common among their circumcised equals.

The views expressed are those of the author and are not necessarily those of Scientific American.

What Is Not Covered By Medicaid

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Although it seems that Medicaid covers practically everything someone needs, it doesnt necessarily provide full coverage. Medicaid does not cover private nursing, for example, nor does it cover services provided by a household member. Also, things like bandages, adult diapers, and other disposables arent covered.

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Family planning, counseling, prescriptions, and supplies to prevent pregnancy. Sterilization . Idaho Medicaid health plans cover medicines prescribed by your doctor unless they are covered by Medicare.

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Does Florida Medicaid Cover Breast Pumps

Medicaid in Florida does not require health plans to cover pumps, but that appears to be changing. The Agency for Health Care Administration is amending the Durable Medical Equipment and Supplies Coverage and Limitations Handbook and Fee Schedule to include coverage of breast pumps with prior authorization.

Is Circumcisions Covered By Insurance

As an infant, a routine circumcision is typically covered by your insurance plan, although one aspect is seen as cosmetic by many people. According to Kaiser Permanente: Newborns are covered for routine circumcision, but older children and adults dont receive the procedure due to medical necessity such as when infection recurring or cancer is growing.

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    Provider Inquiry Newborn Spreadsheet

    peaceful parenting: Are YOU Paying for Infant Circumcision?

    If you know the mother is pregnant, Medicaid eligible, and her unborn child does not have a number, you may have the baby added by emailing a password protected Master Unborn Provider Spreadsheet to the statewide DCF email address identified on the spreadsheet. This spreadsheet can also be used to contact DCF to request assistance regarding missing eligibility for newborns or issues concerning incorrect demographics such as discrepancies in dates of birth.

    Please review the Provider Unborn Update Spreadsheet Completion Guide for further instructions on completing and submitting inquiries to DCF.

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    Online at ACCESS Florida, or submit a paper application by mail, fax or in person to a local service center. For help with the application process, call 866-762-2237.

    Eligibility: Children up to 1 year old with family income up to 206% of FPL children 1-5 with family income up to 140% of FPL children 6-18 with family income up to 133% of FPL pregnant women with family income up to 191% of FPL young adults 19-20 with family income up to 30% of FPL adults with dependents with family income up to 30% of FPL.People who qualify for Supplemental Security Income automatically qualify for Medicaid. For information: SSI-Related Programs Financial Eligibility Standards

    Does Florida Medicaid Cover Infant Circumcision

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    Dont take this as definitive information you must contact Medicaid in Florida for the absolute accurate information. But in general, medical plans do not cover routine circumcision. This is because medical plan administrators understand that routine circumcision is elective and cosmetic in nature. It is likely to be different if there is some medical indication that infant circumcision is necessary. Hygiene is often cited as a justification for circumcision, but intact men can and do learn to care for themselves adequately.

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    Does Medicare Cover Surgery

    Medicare Part A and Part B cover surgeries only if the procedure is medically necessary to the patients health. Therefore, cosmetic and dental surgeries are not covered.

    Youll need to alert your Medicare about any surgeries. During this time, it may be a good idea to check your deductibles to see if youre eligible to receive 100 percent help from Medicare.


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