Does Private Insurance Pay Any Or All Costs for Tubal Reversal?

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.