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.
Filed under Tubal Reversal by 
How Tubal Reversal Surgery Is Done
If you are interested in getting tubal reversal surgery done, you may want to know how this operation is performed. How your tubal reversal surgery is done depends upon the doctor and/or clinic you choose for the surgical procedure. Each doctor seems to have strong reasons for how he conducts this procedure. Below you will learn some of the basics of how it is performed by one practitioner.
Tubal Reversal Surgery Reverses What Was Done During Tubal Ligation
Essentially, during your original tubal ligation, your fallopian tubes were cut and then they are clipped, had rings added, ligated, coagulated (actually with this procedure the steps are the other way around), or otherwise made so the cut ends could not come into contact with each other. This will prevent an egg from making the journey to the uterus and likewise, and more importantly, prevent sperm from traveling up the fallopian tubes to meet and fertilize the egg.
Step One in Tubal Reversal Surgery – Get to Know What the Lay of the Land Is
Although your surgeon may very well have an initial consultation to review your tubal ligation records, he still may not really know what he is going to find when he starts the operation. It’s astonishing how some records can be wrong or even incomplete.
This means the first step may very well be a laparoscopic view of the tubes to determine length and the overall health of all operating parts (ovary, fimbriae, uterus, etc.). This incision will most likely be made in your belly button. He will insert the laparoscope and view these organs.
Making the Incision for Your Tubal Reversal Surgery
Next will come the actual incision for the tubal anastomosis itself. Generally this is done just above and parallel to the pubic bone below the start of the pubic hair. It will be a 3 or 4 inch incision depending upon your surgeon.
You will find, however, that some tubal reversal doctors will continue with the surgery using a laparoscope. To learn more about laparoscopic tubal reversal, just visit the linked page.
How Your Doctor Views the Field of Surgery
The next choice made during the tubal reversal surgery will be how your doctor performs the surgery itself to remove the clips, cauterized areas, scars or whatever to have clean live tissue of the tubes to join. You will find some doctors swear by surgical microscopes and others have performed thousands of surgeries using surical loupes (magnifying lenses).
Each has his reason for what he uses. Most likely, it is a simple matter of how the surgeon was trained. You may wish to discuss this with your doctor, but perhaps looking at his success rate for patients with your given statistics (age, time since original surgery, previous births, etc.) will tell you more.
Suturing During Tubal Reversal Surgery
Regardless of how your surgeon views the operating field, he must remove the damaged and scarred tissue from your tubes and then reconnect the two pieces of each tube. Your doctor will next use micro sutures to reattach the separated parts of the fallopian tubes.
Here again is another step wherein the surgeon’s own preferences are made as to how the suturing is done. One surgeon I have discussed things with prefers to suture the fallopian tubes back together by layer but only the outer two layers.
Once the separated parts of the tubes are brought together, there are three layers where the micro sutures can be applied. Whether all three layers have sutures or only the outer most two (muscularis and serosa) again depends upon your surgeons preference and experience.
The inner is the thinnest and the one with the cilia that help to move the egg down the tube to the uterus. By not suturing this layer, this surgeon feels that he minimizes scarring as the two pieces of the tubes heal together thus increases your chances for a successful pregnancy and minimizing your chances for an ectopic pregnancy.
But he does suture first the middle layer and then the outermost layer to be sure there is a strong connection between the two parts. Furthermore, he will even suture the tube to the abdominal wall just to give it some support while healing.
The extra layer (lumens) will require more time for the surgery and you being under anesthesia which some doctors will try to avoid. The longer you are under, the more that can happen. However, the surgeon mentioned above usually only takes an hour to do the surgery anyway and you can see the benefits to doing it his way.
Testing for a Clear Connection After the Suturing
Different doctors have different ways to test this but you will want one that does some kind of testing for a clear pathway before he begins sewing you back up.
If he is one that prefers to use a stent, this will be threaded through the fallopian tube from the uterus through the fimbriae first to be sure there is no blockage within the tubes themselves.
Some doctors do not use a stent because they believe it may cause some tissue damage itself. Those that do use it point to statistics which show a higher rate of pregnancy if one is used.
If a stent was not used, your fallopian tubes may be flushed with saline solution or a chromotubation will be performed. Essentially this is flushing the tubes with a dye to check to see if they are open.
Anesthesia During Tubal Reversal Surgery
The form of anesthesia that is used may be a general which puts you under or an epidural so only sensation in the area of the surgery is blocked. You may be able to ask your doctor for the one you prefer. This decision could also be up to the anesthesiologist. All of this will most likely be determined by the form of surgery the surgeon conducts.
Type of Sutures Used for Tubal Reversal Surgery
Lastly, the sutures used in the tubal reversal surgery may be permanent or they may dissolve. This will vary with location and your chosen doctor’s preference based on his experience and surgical methods. This applies to the sutures on the fallopian tubes as well as the suture(s) used to close the incision.
Whether you just clip off the knot on both sides of the incision or clip on one side and pull depends upon whether dissolving sutures were used or not. Be sure to follow your doctor’s post-op care instructions to the letter. This care can go a long way to helping your tubal reversal surgery to be successful in the end.
Filed under Tubal Reversal by
