What are my options for getting a varicocelectomy?
January 28, 2017 1:00 PM   Subscribe

A urologist has recommended a varicocelectomy. He's a specialist who has made a career performing these procedures and as such he does not take insurance. I can't really pay out of pocket. I have insurance and my understanding is that the procedure is covered but my out-of-network coverage is terrible. How do I go about getting this done in network? Can I ask my urologist for a referral/prescription? Will a different provider still have to make an assessment/recommend the procedure before performing it? How does this work?
posted by anonymous to Health & Fitness (6 answers total)
He's a specialist who has made a career performing these procedures

Please, get a second opinion.

The presence of a varicocele does not in itself mean surgical correction is necessary.

If the next doctor agrees, then call your insurance and ask what the best options are for getting this covered. Sometimes, a letter from a doctor specifying "medical necessity" can be helpful in getting as much as possible out of the insurance coverage you have.
posted by Michele in California at 1:10 PM on January 28, 2017 [5 favorites]

Came in to say what Michele in California said: get a second opinion, please! Of course this doctor wants you to get the procedure that is his particular specialty, he's got lot$$$ of reasons to recommend you have this done. What you do need is an opinion from someone neutral, someone who doesn't have anything to personally gain by recommending for or against it.
posted by easily confused at 1:23 PM on January 28, 2017 [2 favorites]

I came in to say the same thing!! It seems suspect, get a second opinion!!
posted by jbenben at 1:26 PM on January 28, 2017 [2 favorites]

Strongly nthing the advice for a second opinion. After years of lurking, this question pushed me over the edge to sign up, just so I could say:

A urologist diagnosed my varicocele 32 years ago at age 14, and it's been noted by every doctor since then. And they've all said the exact same thing: It's no problem.

The only reason I'd want it taken care of, they've told me, was if it got in the way of fathering a child by obstructing the release of sperm. My two sons are evidence that wasn't an issue.

Incidentally, another urologist recently got a very good look at the situation when he performed my vasectomy. And he didn't suggest a varicocelectomy.

I'm no doctor, but it sounds like this guy has made a career out of performing a procedure that's usually unnecessary. I'd be very suspicious. Do your nuts a favor and talk to a general urologist.
posted by ahthefrench at 5:11 PM on January 28, 2017 [3 favorites]

Unless it's hurting or it's making you infertile I wouldn't bother. Like ahthefrench I have had it as long as I can remember and have had no problems having kids.
posted by Joe Chip at 9:05 PM on January 28, 2017

If there seems to be a fertility issue, it may not be yours alone. Consult a fertility specialist who will look at the big picture, not a one-trick urologist.
posted by JimN2TAW at 2:44 AM on January 29, 2017

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