Sterilization

Medicare covers sterilization procedures only when they are medically necessary to treat an illness or injury (for example, hysterectomy or bilateral oophorectomy for tumors, or bilateral orchiectomy for prostate cancer). Elective sterilization and sterilization performed as a preventive measure (including to avoid pregnancy or prevent possible mental-health effects) are not covered. Claims must be supported by medical records and pathology evidence showing the procedure was performed for treatment, otherwise payment will be denied and recouped.

"Sterilization procedures are covered when they are necessary to treat an illness or injury rather than performed solely to cause permanent infertility."

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