Inter-Com: Newsletter of the Manitoba Medical Association, page 6

Neonatal Circumcision— Insured or Uninsured?

Pursuant to the provisions of the Health Services Insurance Act, only medical services which are “medically required” are insured services. If a medical service is not medically required, it is an uninsured service. Therefore a circumcision that is not medically required is uninsured.

The vast majority of neonatal circumcisions are not medically required since medical indications for circumcision are rare. (See Guideline #914 of the College of Physicians & Surgeons, for more information.) Circumcisions which are performed solely for religious, cultural or aesthetic reasons, and not for any medical indication, are uninsured services.

As is the case with all uninsured services, physicians who perform circumcisions for reasons other than medical necessity are at liberty to direct bill the patient’s family for the service. (Several Manitoba physicians currently direct bill for this service.)

Despite the foregoing, some physicians choose to bill Manitoba Health for circumcisions that are performed for reasons other than medical necessity, and Manitoba Health continues to make it a policy to pay for these services, at a rate of $19.50. (Manitoba is the only remaining province in Canada which pays for this service under our provincial health care plan.) Nevertheless, regardless of Manitoba Health’s policy, the fact remains that circumcisions which are not medically required are uninsured services. As such, unless you are content to receive payment from Manitoba Health in the amount of $19.50 for performing this service, the Association recommends that you direct bill for the service. In setting your fee for the service, bear in mind that the rates currently charged for this service are in the range of $75 - $150.

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