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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Tubal Ligation Side Effects – Are You Being Told What You Need to Know?
As a method of effective birth control, tubal ligation is very commonly used by as many as one million women every year in the USA. Mostly used by older women, or those who feel they no longer wish to bear any children it has become widely used and has been used for about 100 years.
However, like any procedure that changes the body’s natural functions, it may have some side effects. Tubal ligation side effects are not necessarily spoken about or mentioned by doctors too frequently, but if considering this method of sterilization, you should insist on all the facts.
Here we aim to give you the basics so that you can go armed with a check list to challenge any silence. It is your body so you have every right to examine any tubal ligation risks yourself.
Symptoms You Might See with Tubal Ligation Side Effects
One the most common post tubal ligation symptoms is psychological and involves a clear regret about having the ligation operation in the first place. The whole issue in itself is naturally very highly charged with emotions, involving as it does the severing of child bearing capability.
For many women, they may have been pressured into having their tubes tied. Or perhaps they made the choice when married and with a full family, not expecting any future change in their lives. Any change in these circumstances can lead to regret or even depression and guilt over having sterilized themselves.
The best treatment is to try to make the right decision before tying your tubes while not under emotional strain. However, difficult this may be, there will always be a chance that this tubal ligation side effect will materialize. Of course the other solution is to undergo tubal ligation reversal which is very effective if you do have this guilt and regret.
Ectopic pregnancy, or ovarian tube pregnancy, is a side effect than potentially can be life threatening and is very serious. For all of that it is not that common and you should not be overly scared by this. Most women have an innate feeling for their own bodies and so the watch word is vigilance.
If you believe you are pregnant then a full test by a professional is essential. You need to explain the serious need for quick and proper results. If pregnant then an operation is likely needed to remove the fetus although certain drugs will be tried first if it is not too far along. Obviously this should only occur where a ligation operation has failed or only one ovary has been isolated due to medical grounds.
Tubal Ligation Side Effects Are Also Called Post Tubal Ligation Syndrome
Most of the rest of the main side effects today are encompassed and collected under the guise of Post Tubal Ligation Syndrome or PTLS. This syndrome was researched and examined by Dr. Vicki Hufnagel in 1980 who identified the various elements. She identified 14 individual Post Tubal Ligation Syndrome Symptoms, although some interact with others as a whole. Some lists containing these tubal ligation side effects symptoms will contain more than 40 items.
To examine in detail each effect is beyond the fact finding of this small informative brief and is deep in complicated medical terminology. What you as a potential tubal ligation side effects patient need to know is the basic outline. Something to highlight specific areas to insist your specialist details them out in plain terms.
Additional Tubal Ligation Side Effects
Menstrual problems and hormonal imbalance tend to be overlooked and go unmentioned by most specialists as two of the more common tubal ligation side effects. Younger patients especially need to be aware of the possibilities of non-normal periods resulting from ligation surgery. This imbalance can lead to major issues with the usual menstrual cycle, caused by incorrect blood flow to the isolated ovaries it does not usually mean that the tubal ligation procedure was incorrectly perform.
Sometimes in extreme circumstances, periods can be debilitating and result in hugely painful cramps, blood flooding or very heavy flow during period cycles. Sometimes tubal reversal is the only option.
Hormonal imbalance due to ovarian isolation can have the same effects as menstruation issues or manifest itself through hot flashes and loss of balance at the minor end of the scale. The effects experienced can be similar to the menopause and if both ovaries are isolated then the ‘ovarian shock’ to the body can be more serious.
It has been reported that this change can lead in some circumstances to bone loss, libido loss, memory loss and low sex drive. Many doctors will prescribe hormone replacement therapy as an effective treatment. Views on the numbers affected by this condition vary depending on the source from very low to around 50%. It is something to be considered seriously as a possibility during tubal ligation recovery. Some women find these symptoms can take a few years to materialize.
Andenomyosis is a serious condition affecting the uterus in women who have already gone through childbirth. Although a lot of the medical profession are unsure as to the reason for this condition, some claim it is one of the tubal ligation side effects resulting from that surgery. It causes dysfunctional uterine bleeding or DUB and a lot of pain. DUB is epitomized by many of the previously mentioned menstrual problems, but can also include hot flashes, mood swings and abnormal body hair growth.
Know Your Risks
For those wishing to undergo tubal ligation surgery, tubal ligation side effects are an issue you have to consider. Whatever the drive or emotions a clear logical head may be needed to properly assess the risks to you and your body. Your health should be the priority whatever the external pressures. Insist on a proper briefing and do not be told just not to worry. While side effects may be minor for you, there is the possibility of something more serious.
This does not mean that there is no solution to any tubal ligation side effects problems if they arise. Post Tubal Ligation Syndrome treatment methods are very effective and tubal ligation reversal is a good solution for many as it reconstructs the ovarian tubes and restores blood flow to the ovaries that were isolated during the original procedure.
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What Are the Average Tubal Reversal Success Rate and Costs?
The average tubal reversal patient often has a myriad of questions, doubts and worries still whirling around inside their head. To be fair, this is not unexpected. This is a big decision and a highly emotional time as well. Typically the most common questions are:
- What is the average tubal reversal success rate?
- What is the success rate of the average tubal reversal compared to the average IVF success?
- What is the average cost of tubal reversal?
- What are the average tubal reversal costs compared to the average IVF costs?
These are the key areas that experience tells us are the focal points for initial research prior to your first consultation. They pop up time and again as women try to decide whether or not to go for tubal reversal surgery
What is the average tubal reversal success rate?
Tubal reversal is a surgical procedure. As such, unlike IVF, the average tubal reversal success rate is around 60-70%, much higher than the success rate of IVF. The surgery either is successful or not. But what you have to read into that figure is that it also factors in pregnancy figures after the procedure, so is a bit of an all in one. So let’s separate those out, as the operation itself is not really affected by age though the outcome is.
The average tubal ligation reversal post-op pregnancy rate is between about 35 and 65%, dependent upon age. One of the best and most complete studies was done by Dr. Berger at Chapel Hill Tubal Reversal Center in 2008. He found that the overall average pregnancy rate after reversal surgery was 66%. This was influenced by age. The highest tubal reversal pregnancy success was in women under 30, being 80%. The lowest figure was for women over 40, which came out at 31%.
What is the success rate of the average tubal reversal compared to the average IVF success?
Although IVF is a long establish infertility treatment, dating back to 1978, the success rates are not that impressive and have not changed much at all
The HFEA (Human Fertilization & Embryology Authority) gives the average success rates from 28th August 2009 for each age group as:
29.6% for women under 35 years old;
23.6% for women aged 35 – 37 years old;
8.2% for women aged 38 – 39 years old;
10.0% for women aged 40 – 42 years old;
3.2% for women aged 43 – 44 years old;
0.8% for women aged over 44 years
This of course is also dependent on other factors, such as the cause of the infertility and the number of embryos replaced. But, overall the figures are not too impressive. The best average tubal reversal compared to the highest average IVF, comes out at over 100% more effective with 80% as compared to 29.6%
What is the average cost of tubal reversal?
When we look at average cost for tubal reversal it is simple and neat. All inclusive deals at private centers come in around $6-7000. However, some prices can drop as low as $5,900 or even lower. But we know the $5900 price tag is for a very qualified and experienced surgeon and we are not so sure about some of those offering tubal reversal surgery for less. However this tubal reversal cost is, in most cases, a one time fee.
For a surgical procedure with a good pregnancy success rate, this is pretty good value for money. Some clinics also offer reduced fee schemes and payment plans as well, which makes this cost come within the reach of more of us.
What are the average tubal reversal costs compared to the average IVF costs?
IVF costs are a whole different animal. Sources quote various average IVF treatment costs as between $10-15,000. But these figures are flawed. They represent just one treatment per cycle and do not calculate in the failure rates we have illustrated above. The figures also seem to ignore the fact that pre and post treatment costs can be hugely expensive. The costs of hormonal drugs are a major part of the treatment and can boost the cost up further if a prolonged course is needed.
The best way to compare IVF against tubal reversal is looking at the fees calculated with the failure rates. So if you take an average cost of one IVF cycle as being around $11,000 to be generous, then at age 35 and under about 3.4 treatments would be needed, meaning costs of $37,400. Start looking at the statistics for older women and the costs soar.
At least with tubal reversal once the operation is done, it’s done. It is a one off cost with the average tubal reversal being around $7000. The percentages are then in the hands of Mother Nature, a romantic meal and soothing music.
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