Anthem covers both medically necessary and elective infant circumcision so long as prior authorization is requested. Can’t speak for other carriers.
No, it wasn’t meant to be humorous. It was my sly way of deliberately breaking the poster’s request not to make a comment about the merits of circumcision. I’m questioning why FGM is banned by MGM is acceptable. I’ve made my point so I won’t hijack the thread.
Sure. I guess I should have been clearer; I’ve been assuming that any of the systems under discussion will cover medically necessary circumcision to the same extent as any surgery, and that the discussion here is about the elective procedure.
I had heard it was customary to give him a small tip.
Moderator Note
The OP specifically asked for factual information about coverage only. Comments like these are off topic for this thread and are inappropriate for the General Questions forum. If you feel that you must make posts like these, take them to Great Debates or the BBQ Pit.
If by “sly” you mean “hijacking the thread” then I agree. If you wished to question why FGM is banned and not MGM, start another thread.
No warning issued.
samclem, moderator
Simul-mod!
So the individual doctor get’s to decide if a given procedure are covered instead of committee of doctors appointed by the provincial health ministry? :dubious:
Under what circumstances would circumcision be medically necessary?
Circumstances like mine. A foreskin that was tight and made urination very painful (apparently, I was a baby when it happened.)
AFAIK it is a commonly recommended treatment (and in many cases the only possible treatment) for pathological phimosis.
Men with my spouse’s birth defect are routinely circumcised because, due to both necessary medical procedures and less than perfect sensory nerves in the region, they are at very high risk of urinary tract infections and in their particular case circumcision reduces the number of UTI’s they suffer. Note, I did not say risk, I said number. They will get UTI’s. Typically multiple ones per year. Pretty much anything to reduce the incidence of same is a good thing.
But that’s not at all a typical situation.
The number of necessary circumcisions is a very low number. Not zero, but very low. They should be a rare procedure.
Speaking purely medically, there are both advantages and disadvantages to routine circumcision (i.e., absent one of the rare conditions mentioned above). There are certainly debates about whether the advantages outweigh the disadvantages, but apparently some doctors conclude that they do. Of course, then you have to ask where to draw the line between “the advantages outweigh the disadvantages” and “medically necessary”.
My husband was in a fire when he was eight, and had to be catheterized in the ambulance on the way to the burn unit. He’s lucky he was circumcised, or they probably would have had to cut a slit down the side of his foreskin, or maybe just circumcised him when they got to the hospital.
Very small boys who need catheters probably have to be circumcised. I worked with a boy with CP who had been very premature and was in a wheelchair. He used the toilet, but had been in diapers until he was 6. He was circumcised, and his brothers (I was told) weren’t. His mother chose to have him circumcised when he was about 6 months old and the severity of his CP was known, because of the possibility that he might have to be catheterized most of his life, and she didn’t want him to remember having it done.
Also, FWIW, I know a mohel who is also a medical doctor, whose specialty is wound healing (works mostly with diabetics, people in wheelchairs with circulation problems, and small-area burn victims). He will circumcise an adult with a local and gas (like a dentist uses), but it is way more expensive than the guy who does the babies. ETA: He does the converts.
You may be trying to make some kind of point here that I’m not getting, but the answer to that question is “yes”. It’s a foundational principle of the Canada Health Act that the doctor – your doctor, the one who knows you and your medical history and is charged with the responsibility for your health outcomes – is the one who makes the judgment call about what is or is not medically necessary, though any patient is of course free to seek a different opinion. This is as distinctly opposed to private insurance where it’s the payer’s bureaucrats who are the gatekeepers to services. The key difference is that medical decisions are decoupled from financial influences. Perhaps that’s the distinction you were not appreciating.
I have to add, in the general context of how circumcisions are covered by insurance in various jurisdictions, that while Tom Tildrum and elbows both claim correctness in the not covered/is covered debate about Canada, as I said, it’s only covered in Ontario (I don’t know about other provinces) if it’s deemed medically necessary. So I must disagree with elbows saying that “It’s covered because most Drs consider it medically necessary. Rightly or wrongly. And that could change over time, of course.” In such a situation it would require a specific medical justification in order to be considered medically necessary. A doctor’s belief that it should be routine isn’t enough, since policy has already been established that it is NOT going to be routine. As a matter of fact, even circumcision for neonatal phimosis – the condition of not being able to retract the foreskin in infants – is specifically excluded as a medical justification because it’s usually outgrown and there are other remedies.
Why would an uncircumcised penis be any more difficult to catheterize than a circumcised one? The urethra isn’t covered by foreskin?
As I understand it, the foreskin in children isn’t always fully retractable. And apparently one is supposed to retract the foreskin when catheterizing an uncircumcised male.
Apparently in a little boy it doesn’t retract. I’m just repeating what I was told. Or maybe it was vulnerable to being injured and getting infected, or something. I can tell you that in a baby boy it doesn’t retract.
Indeed most foreskins do not easily retract until age 4 or 5 years of age and often not fully until later.
OTOH one does not need to and should not forcibly retract the foreskin to catheterize an uncircumcized preschooler or younger’s penis. You know where the opening is going to be and it can be done without seeing the opening just fine, by feel. IF and only if the foreskin is easily retractable then retract and cleanse the opening before catheterizing.
Rivka I thought converts only needed a symbolic nick?
Converts who are already circumcised need a symbolic prick “additional blood for the covenant”; but if they are not already circumcised, they need to be fully circumcised.
What I meant was does the provider have total freedom in deciding what treatments to perform or do they have to follow guidelines from the provincial health plan (ie the plan will only cover circumcision for diagnosis X & Y, but not Z)? In the US we do have a single-payer insurance for the elderly & disabled (Medicare), but it issues guidelines on everything what what’s covered & when it’s covered to how claims have to be filed (guidelines which many private insurers use as a basis for their own rules when they don’t just copy them outright).