Will Health Insurance Pay For Tubal Ligation Reversal?
Did you know that 25% of all women who have undergone tubal ligation, request to have it reversed in the first 3 years following the operation? That is quite a hefty percentage by anyone’s reckoning. These ladies often find themselves desperate to feel whole again, either by choice or due to medical needs. But the cost of the procedure can be a real stumbling block. Most of us have or try to keep up medical insurance. But does private insurance pay any or all costs for tubal reversal?
The Bad News on Whether Private Insurance Will Pay for Tubal Reversal
The big picture answer has to be no. This is a fair assessment for most people who find themselves in this situation. You have to remember that insurance companies have no emotions when it comes to business. All they are interested in is reducing their risk profile. That is what they do, manage risk.
To them tubal ligation in the first place is mostly a choice made by a women who no longer wishes to bear children. Therefore it is not essential medically that it is done and so why would they insure that. However, many health insurance companies will cover getting your tubes tied as it lessens the number of people covered on one policy which is a way of lessening risk.
However, this same measure of risk assessment is exactly the thought when considering will insurance pay for tubal reversal. Again it is an elective procedure made out of choice. If you do have a tubal reversal and more children, you increase their risk by adding more people to a policy with more potential problems they have to pay out to cover.
What You Should Do to Find If Your Health Insurance Pays for Tubal Reversal
Having said that, we would always advise you to first of all read of your insurance policy in detail before you go any further. This is not the easiest task, with all the lawyer speak it is usually written in.
Secondly phone and speak to your company to check their current position. You may need some details from your physician before you do this though, so make sure you have everything at hand.
Will Health Insurance Pay Any Costs of Tubal Reversal?
Now you have had a look as to whether the insurance will pay for the tubal ligation reversal, it is on to step 2. The question again that you need to look at carefully is “does private insurance pay any or all costs for tubal reversal?” Please note the “any or all” in there. Really we should have asked as to whether they will pay for any part of the whole procedure.
Now remember that the operation itself is just the end point of a long journey. On the way there will be consultations, examinations, blood tests, other tests and so on. Consider each of these steps as a discrete part and look at what they could be described as. Then look again at you policy and see if it will cover any of these costs if properly described and coded.
A Health Insurance Company That MIGHT Pay Some or All Costs of Tubal Ligation Reversal Surgery
There are one or two niche companies who will provide insurance for tubal reversal surgery such as Blue Cross Blue Shield. But these are few and far between and will depend upon your location and other factors. Check out the opportunity here or click on the banner below to fill out a form so you can talk to a Blue Cross Blue Shield associate.
Some health insurance companies will even agree to full payouts depending upon all kinds of conditions, although you will probably have to pay first and then file a claim. If on any of these investigations, you can claim at all, then you will need to ensure you use the right CPT code for tubal reversal surgery or any of the parts. For example surgical reversal (Tubal anastomosis) is 58750. Your surgeon’s staff will be able to provide you with all the correct codes usually.
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Is There Such a Thing as Tubal Reversal Insurance? How to Get Insurance Coverage for Your Tubal Ligation Reversal
The burning question that many women have when wanting tubal ligation reversal surgery is how to pay for the costs. First thoughts turn to medical insurance policies and whether they are covered. Unfortunately, most insurance companies have no knowledge of tubal reversal or count it as a voluntary or elective operation. Tubal reversal insurance would seem to be a non-existent entity, but this is not exactly true and there is light at the end of the tunnel for many who are desperate to undergo the procedure.
What May Be a Good Reason for Tubal Reversal in Order to Get Tubal Reversal Insurance Coverage
First off we need to split off the medical need to have to undergo tubal reversal which can be a determining factor when it comes to tubal reversal insurance coverage.
Many women suffer from Post Tubal Ligation Syndrome symptoms after tubal ligation. These symptoms may be minor, but where they are more serious or long lasting, tubal reversal surgery is the only effective treatment. Therefore, tubal reversal is no longer an elective procedure and is a medical necessity.
This is a simpler solution and one that is more likely, though not guaranteed, to get a positive response from insurance companies especially with the backing of your doctor. For this type of situation, tubal reversal insurance might be more readily available.
Checking Out Tubal Reversal Insurance for Others
However for most other woman who are desperate to reverse their tubal ligation, there is no specialized insurance that covers tubal reversal. But don’t be put off by that statement, as it is quite sweeping and broad.
You need to examine any current policy to see if your health insurance covers tubal reversal at all. Look at the exclusions and exceptions in the policy small print. This can be a challenge in itself as legal speak is not the most friendly language. If need be get a friend to help or your union legal rep if you have one
Even if you cannot get any tubal reversal financing for the whole operation, certain parts may be covered. For example, you might get part of the operation, the consultation, the anesthesia or certain lab procedures covered. If there is a loophole like this then you will need to collect the insurance codes from your specialist to file your return.
Pay First and Get Paid Later – Maybe
Be aware of the whole payment system as well. Many surgeons will not wait to accept payments from an insurance company. They may not want to have to hire staff that do nothing but deal with insurance providers. And the insurance company may not want to deal with a third party. You might still end up as the pig in the middle.
This of course means you may have to take the risk on getting payment after you have paid up front. If you can get a definite verdict on the tubal ligation reversal insurance costs parts that they will pay then you at least know how much you will still have to find to fund it ultimately. If you do find your health insurance provider says they will pay for parts of the procedure, be sure to get it in writing. You sure don’t want to hear after filing that the person you talked to didn’t know what they were talking about.
Will Blue Cross Blue Shield Cover Tubal Reversal Surgery?
Although there is no company that specifically offers tubal reversal insurance policies, it is now well known that Blue Cross Blue Shield does support tubal reversal surgery. In fact if you look around the message boards on the internet you will find that Blue Cross Blue Shield has a very good reputation for payout, percentages and customer service.
This is a real deal if you have coverage. However, this can be a harrowing and distressing experience as you deal with all the emotional pressures involved in trying to arrange the whole process. You can find stories of their patience in dealing with claimants over long periods of time, as sometimes check payouts can take several months to process. Blue Cross Blue Shield also has a good track record for 100% or high payouts as well.
Obviously this does depend on your policy, your personal circumstances and the state you are in as well.
Will Blue Cross Blue Shield cover your tubal reversal surgery? As already stated that will depend upon your personal situation.There is only one way to find out and that is to talk to them. You can check out Anthem Blue Cross Health Insurance Plans? Visit for a Free Quote.
Tubal Reversal Insurance Codes
However you finance your tubal reversal, through your insurance or whichever company you are dealing with, communication is the key. Give them the facts clearly and promptly and in as much detail as you can. You may be asked to go through testing and a process of evaluation before they will consider your claim.
Everything you do with the insurance companies, whether partial, full or pre-test processes will be covered by insurance codes that you should give. These special tubal reversal codes will also be need to be checked to be sure if you are covered in the first place. A short summary of these insurance codes is as follows:
Surgical reversal (Tubal anastomosis) – 58750
Tubal sterilization (bilateral tubal occlusion) (628.2)
Diagnosis code (ICD-9)
Find out from your tubal ligation reversal surgeon or more precisely from his staff any additional codes you may need. These will include codes for lab work, the anesthesiologist, and pain medication among other things.
What Your Tubal Reversal Doctor May Help You With for Tubal Reversal Insurance
If you have chosen your tubal reversal doctor well, his or her friendly staff may help you fill in the forms. Insurance forms are not the easiest things to decipher and help may be essential to do it correctly. They do this, if you are fortunate, even if they do not accept payment direct from the insurance carrier. Many are experienced enough to know how hard this process is and how emotionally draining it is.
Remember that after the surgery has been completed that you will need your doctor to provide you with an itemized super bill. Without this your tubal reversal insurance company may refuse to pay out any monies. It is worth confirming with your surgery center that they can and will do this. It is very important.
So although tubal reversal insurance does not exist as a specific policy, there may be a chance to get parts of the procedure covered. The watch words here are detail and perseverance.
Try not to get knocked back by a straight out refusal first of all. Examine your policy closely and that of your husband, who may be covered for you from his. Use the codes that you need to speed up the whole process. And remember you may not get any money until the operation has been completed, so you may still have to find the tubal reversal funding from other sources rather than using tubal reversal insurance to start.
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Can You Really Get a Free Tubal Reversal? Five Different Ideas Which Might Not Pan Out
For many women desperate to reverse the effects of tubal ligation surgery, their hopes are frequently dashed by the costs. Insurance coverage is sparse at best, credit scores makes rule them out of loans and they have no generous benefactors. Unfortunately, women from a low income or deprived background are the biggest losers in the search for regaining fertility.
However, for a few select couples who fit the profile, there are some limited chances of a free tubal reversal out there, although as you would imagine they are very specific and very closely policed and monitored by their founders. The two main organizations which provide a supposedly free tubal reversal are the Ministry of Blessed Arrow and the Lord’s Heritage Ministry.
Blessed Arrow for a Free Tubal Reversal
The ministry of Blessed Arrow was founded in 1997 by two couples: Brad Irons and Dawn Irons and Rick and Deni Breitenbach. These two married couples set up the ministry specifically to assist other Christian couples in restoring their fertility by funding their tube reversal surgery.
While this may seem an easy way to get free tubal reversal surgery, it does not work this way at all. There are a very specific charter and application instructions if you are wanting to apply for reversal funding. You will have to visit the website and read through it thoroughly. (Due to the exclusive nature of the ministry we will not post a link to the site nor to any other places discussed below.)
Next your motives for wanting reversal surgery will be examined by you joining the online discussion group, introducing yourself and providing a sort of resume on how you got into the situation you find yourself in.
Following this introduction the real business starts. If you are looking for tubal reversal financial assistance then there is an application process to go through, which also carries a $30 administration fee.
It is well to examine all aspects of the group and their ethos before deciding whether to join or not. There is no place for single women, non-married couples or divorcees. The application has to be made in the names of and filled in by both husband and wife. If accepted, which can take several months, then the Blessed Arrow will set up a bank account in your names and put the case to their community. You will see the names of current fund raising couples on the home page and the reasons for each.
Get a Free Tubal Reversal with the Lord’s Heritage Ministry
The second possible source of a free tubal reversal, the Lord’s Heritage Ministry, will introduce themselves to you as, “an internet-hosted, Bible-based, Christian sterilization reversal ministry” (Quote from their website).
Similar to the Blessed Arrow in their approach, there is a very extensive charter, which should be read in full, in detail and digested, quoting as it does frequently from Christian scripts. The charter stresses the Lord’s Heritage principle of restoration of bodies to the way God made them, along with the positional arrangement of the ideal family unit.
As with the Blessed Arrow, applications are only welcome from married couples who will both have to fill in the parts of the application form. After submission you will have to go through a phone interview with the ‘Servant Team’ and await a letter to see if you were successful.
Again the process may take some time as they are very careful and thorough, to make sure all applicants fit their very specific beliefs. Looking at the charter, as a family seeking funding or just a standard member you will be expected to make a donation every month. So this is not exactly the free tubal ligation reversal you might have been expecting
What you must remember with both of these Christian organizations is that just because you get accepted into the process of fund raising, it doesn’t mean that you will be funded. Members are free to give to whichever fund they choose.
This short factual piece is not here to judge or question any organization either. But as with all options available for free tubal reversal, you must decide if an organization or charity’s principles sits comfortably with your own beliefs. Do not try to change everything you believe in just because you are so desperate to have the reversal surgery. Selling yourself will haunt you and could have a profound effect upon your future happiness.
These organizations have specific goals and specific requirements that are not ideal for everyone out there. If you are considering joining, then you must read everything thoroughly that you can find before you commit. Only then should you be able to make a fully informed choice.
Apply to the Gift of Hope If You Are in the Right Location
Besides the two Christian ministries above that seem to be well known, finding a free way to have tubal ligation reversal is extremely difficult. There is one other, which is very specific geographically and a bit of a long shot. This is the Gift of Hope scheme at the Fertility & Women’s Health Center of Louisiana. It has been running very successfully since 2006 and is directed towards infertility treatments such as IVF.
To be eligible to apply to the fund, you must be a resident in Louisiana itself, paying taxes, earn in total less than $80,000 every year and not be covered by your insurance company for the treatment. Although it is directed towards in vitro fertilization, it is worth finding out if they will also support tubal reversal, as they do carry out that surgery at the center.
Two Last Ideas for an Almost Free Tubal Reversal
If none of the above options are available to you, or do not appeal to your beliefs or situation, then the well is pretty dry.
One other idea is to actually call around to the clinics and centers to see if any such free tubal reversal funding projects are running in them or if they know of any. Don’t bet on finding any such thing though a clinic just might know of another ministry or local non-profit that might help.
One last thing which we have seen suggested is to see if your clinic will carry out the operation for free if you donate eggs. Of course this will only work if you have your free tubal reversal done at a fertility clinic or they are associated with one. It will not work at a clinic that specializes in tubal ligation reversal.
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