Circumcision Rates Lower In States Where Medicaid Does Not Cover Procedure
- Date:
- University of California – Los Angeles
- Summary:
- 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.
Story Source:
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
| Age |
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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
Services that include imaging such as x-rays, MRIs or CAT scans. They also include portable x-rays.
COVERAGE/LIMITATIONS:
- – 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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No Aca Medicaid Eligibility Expansion In Florida
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
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ADvantage Waiver Program
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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
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
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.
Does Idaho Medicaid cover vasectomies?
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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Does Florida Medicaid Cover Infant Circumcision
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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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.
