Will Health Insurance Companies Pay for Tubal Reversal Done for Tubal Ligation Side Effects?
Most women who undergo having their tubes tied have few if any side effects of tubal ligation to cope with. However in a small proportion of cases, Post Tubal Ligation Syndrome may be encountered. This is a hotly disputed area if you do suffer from the symptoms with many doctors refusing to accept the existence of PTLS at all. Here we will look at Post Tubal Ligation Syndrome and insurance companies view on the subject.
Tubal Ligation Side Effects
Some 14 tubal ligation side effects were well documented by Dr. Vicki Hufnagel in 1980 in her very comprehensive study of tubal ligation patients. Some of the effects are minor, both physically and psychologically, and may fade with time.
But unfortunately there are recorded cases of a much more serious nature. Violent mood swings, depression, hair loss and heavy bleeding represent real dangers and risks both to the patient and those around her.
How to Recover from Post Tubal Ligation Syndrome
In such serious cases, the only and best answer is tubal ligation reversal in the hopes of restoring the body’s balance. This is where things get a little tricky to say the least. Not with the procedure, which is highly successful and safe, but with financing this reversal operation. This is down to the fact that not every medical profession agrees with the studies that have been done so far.
Tubal Reversal and Health Insurance
A standard tubal reversal, not driven by a medical need, generally will not qualify under your insurance if done for non-medical conditions. It is classed as an elective procedure. Pretty much all private health insurance companies take this view.
Claims for a tubal reversal due to Post Tubal Ligation Syndrome and coverage from insurance can result in a different outcome. Where we are talking about pressing medical needs, or a recommendation by a doctor, we start to approach a borderline decision for these companies. But Post Tubal Ligation syndrome and insurance companies don’t always see eye to eye
In all likelihood, your health insurance company will want to see all of the medical files associated with your case. They may appoint their own experts to assess it and maybe even examine you themselves.
Problems PTLS Sufferers Face with Insurance
For PTLS sufferers this is where problems can start as it is not widely accepted or recognized in the medical profession. You may have a fight on your hands. It is best to accede to their demands in the first instance of letting them see your medical records especially if your doctor is on your side and has well documented your case until you know where you stand.
The key in all of this is to work closely with all of your health care professionals and speak to your insurance company as early as possible. By actually introducing this dialogue at a stage where they do not feel pressured by its urgency, you might actually get a few breaks.
If this still doesn’t work, there are some insurance companies, such as Looking for Anthem Blue Cross Health Insurance Plans? Visit Blue Cross Blue Shield (and you can get a free quote from eHealthInsurance
), who will pay for reversal operations in certain locations under certain conditions. This will often pay for reversal to remedy the tubal ligation side effects and will benefit the suffering patients accordingly.
Get Part of Your Tubal Reversal Paid For
In any event even if your insurance company will not finance the whole procedure, you might be able to exploit a loophole to cover a portion of the surgery. This is likely to be the pre and post examinations/consultations, testing and some exploratory costs. So you could be looking at getting things like any initial consultations, blood tests and some parts of the operative costs like the anesthetist paid for.
What is the most important thing is to ensure that your Post Tubal Ligation Syndrome symptoms and the health insurance company are dealt with as swiftly as possible before your symptoms make your life unbearable if you should have the worst of the tubal ligation side effects.
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Tubal Reversal Success Rates – How Effective Is Tubal Ligation Reversal?
Before we begin to discuss how effective is tubal ligation reversal,or the tubal reversal success rates, let’s start with a little background about tubal ligation numbers.
Every year over 600,000 women choose, or in any event undergo, sterilization via tubal ligation or other associated methods. For many this is the right decision at the right time.
However a proportion of these often come to regret their choice or wish to reverse the procedure due to changed circumstances. The official figures are around 25% regret their previous surgery within the first 3 years following the sterilization procedure. If the reverse is due to a desire to bear a child again, then it is sensible to know how effective is tubal ligation reversal.
Tubal Reversal Success Rates – Studies on the Effectiveness of Tubal Reversal
For a lot of women in the lead up to a decision on tubal reversal, there is a search for knowledge and information. The question as to how effective is tubal ligation reversal can be all absorbing. After all, who wants to spend thousands without having some knowledge as to what the tubal reversal success rates are.
Unfortunately the quantity and quality of information can be sparse to say the least. Figures are quoted in quite high percentages as to the “success” of the reversal procedure. But more often than not, there is no qualification, clarification or a lack of solid evidence to back them up, even if true.
In fact although you would assume that a “success” would mean pregnancy, it is difficult to know. Is it just the successful completion of the operation itself in a technical way? We know from medical figures that fallopian tube surgery is generally successful about 98% of the time from hospital records. But that in itself does not guarantee pregnancy will follow.
There can be issues if the 2 ends of the fallopian tube being joined are of different diameters, or if the length of the 2 halves is less than about 4 inches. There are other factors to consider when looking at how successful a tubal ligation reversal may be. The method of ligation, patient age and experience of the surgeon all play an important part.
As there have been no government or academic studies done on tubal reversal success rates, what are you to do? Has anyone actually done a proper study from surgery to pregnancy, or the lack thereof, to determine the success rates of tubal ligation reversal? Are there actual figures to show the pregnancy rates for all the different circumstances? This is important for any women thinking and wondering just how effective is tubal ligation reversal.
Chapel Hill Tubal Reversal Center Study on How Effective Is Tubal Ligation Reversal
The only real in depth study that has been done in significant numbers is that by Dr. Gary Berger of the Chapel Hill Tubal Reversal Center. This was done with records starting in 2000 and going through 2008 and a follow up report published in 2009. If you need to look, it is called the Tubal Reversal Pregnancy Study 2009 Pregnancy Rates by Age and Tubal Ligation Method.
If we crudely summarize, then the study showed that on average, that pregnancy rates, or effectiveness, of tubal ligation reversal was around 66%. Now that was an averaging out of the pregnancy rates recorded, by cross referencing age and original ligation method. What was clear was that age was the biggest factor by far.
To look in detail at how good is tubal ligation reversal is a rare privilege. The actual detailed figures from this study are split into 3 parts.
Pregnancy Rates – How Effective Is Tubal Ligation Reversal
The first of those looks at 3 age groups and the variations across those groups for the various original ligation methods used. One thing was very clear, is that women aged under 30 had a much better chance of pregnancy than the other groups. 80% was the figure and that dropped rapidly across all methods to a figure of 31% when over 40.
The effect of the original ligation method was not as much of a factor in determining how effective is tubal ligation reversal. Ring or clip ligation came out top of the pile with 72% and 75% respectively.
Finally we can look at the cross referenced figures which clearly shows age as the determining factor again. The best statistics show that those women under 30 who had undergone clip form of tubal ligation surgery had a massive 90% chance of the tubal ligation reversal being effective and resulting in pregnancy. However, the number of women under 30 wanting a tubal reversal is a smaller group as most of the women wanting this reversal surgery were in their 30s.
Even when over 40, it appears that this ligation method vastly reduces the failure rate, so that pregnancy has a 31% chance. The figures for Ligation/Resection are 77% for under 30 patients and 31% for those over 40. The best type of tubal ligation to want to reverse for the over 40 group according to the Chapel Hill Tubal Reversal Center is ring tubal ligation as it had a 46% pregnancy rate.
What About the Tubal Reversal Success Rates of Other Tubal Ligation Procedures
As a side point, we need to talk about Essure sterilization. This is a very different method of tying the tubes, where the insertion of a metal coil encourages the tissue in the fallopian tubes to grow and seal them up. It was often thought that reversal success would be minimal from this method.
This has not been the case though. Dr. Berger has already seen success with this reversal type. Given that the population of women who have had reversals of Essure or even Adiana sterilizations, there just is not a good population size to give out success statistics. Suffice it to say, there have been some successes.
How Successful Is Tubal Ligation Reversal? – Tubal Reversal Success Rates
Now the really great thing about these figures, is not only to demonstrate how effective is tubal ligation reversal in itself, but how there needs to be careful consideration of ligation method prior to any sterilization. Of course, when tying your tubes, who thinks they will want a reversal some day.
It would appear that if you are under 30 then going for rings or clips Fallopian tube method will give you the best chance overall. But as you creep towards 40, although better, the gap between the methods and successful reversal recovery drops. Of course Essure and Adiana removal really is the bottom of the pile being a much more involved tubal ligation reversal proces, so perhaps should only be considered as a last resort.
Of course all of these tubal reversal success rates will also depend on the skill of the reversal surgeon on the day which will determine how effective is tubal ligation surgery for you. Keep this in mind besides everything else when you begin looking around for a surgeon to perform your tubal reversal.
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Different Styles of Tubal Reversal Layaway Plans
If you are considering or in fact are determined to undergo tubal reversal, financing this procedure may well be the toughest thing to conquer. That does not mean that the problems this entails cannot be solved. For underneath all the emotional stress and heartache, there can often emerge a strength or purpose and determination that we never thought was there. One of the best ways to achieve this is through schemes known as tubal reversal layaway.
For many couples trying to find tubal ligation reversal financing, trying to get a personal or other loan more often than not hits a dead end very quickly. Inability of loan companies to help or often poor credit scores mean refusal all too often.
How a Tubal Reversal Layaway Plan Works
But there is hope through the payment plan method. What we mean here is finding a layaway tubal reversal strategy of getting our personal finances to pay for the operation. So little by little, week after week and year after year, if necessary, money is put aside and gradually adds up to that magic total. There are several ways of achieving this effective layaway tubal reversal financing.
Use Your Savings Account as a Tubal Reversal Layaway Site
Well the obvious one is just putting money aside regularly into a savings account. This simple self-imposed tubal reversal layaway is often the most common first choice and the most common one that fails to achieve its goals. Despite the initial determination and intent, the problem is the money can be easily got at, taken out and spent.
Put it this way, you are desperate to start a family, or expand it, again and that is so right for so many couples, for whatever reasons. But what price the roof over your head or food in the cupboard or keeping the car running so you can go to the job? If something major happens, that savings account is all too easy to reach.
It is such a hard choice, but one that logic has to rule on. So many women put aside their dreams and hopes to make sure their current family does not suffer. Such a wrench of the heart and one that would play on the mind causing even more stress. Do we or don’t we pull out the money to make things easier?
Look to Your Employer First for a Tubal Reversal Payment Plan
But there are some great alternatives that really offer a chance of completing a tubal reversal layaway plan. The first is through what are known as flex-spending accounts. Some employers have schemes whereby they offer a special health savings account.
If you are a member, they can offer you an interest free, and tax free, loan. This money can be taken straight away but then has to be paid back by a payment plan of installments through your paycheck. Not exactly a tubal reversal payment plan as the money is up front, but a good alternative to loans.
Use Your Doctor to Hold Funds in a Tubal Reversal Layaway
But the main tubal reversal layaway funding method that most couples use is actually offered by many of the medical centers themselves. When trying to arrange your reversal you will obviously be concerned with the details of the surgery itself. But the one question you must ask is “do they offer payment plans for tubal reversal surgery?”.
If the answer is yes, then this could be the real answer to your problems. But there is one important thing to consider and that is which way around you want to structure the tubal reversal layaway payment schedule?
Option 1:
You schedule your big day and work backwards from that. Calculate how much you need to put in each week or month to hit your total. For example, if the tubal reversal cost is $5900 and your date is in 12 months time, that is $492 a month or $114 a week. This will give you the hard headed calculation to temper your heart. Be realistic, because remember, if you don’t hit the target the operation is off and you loose the scheduling fee you will have already paid.
Option 2:
If you cannot commit the same amount every month, then look at saving first and then scheduling. A lot of surgeries will set up a plan for you. You pay in as much as you can afford whenever you can and as often as you can. Then when you reach the required total, they will schedule you in.
Many couples prefer this flexible approach as it helps through any lean times. Many top up or finish off with tax rebates or gifts received from family members.
But remember whichever way you do choose to go with your tubal reversal layaway funding, do not lose sight of that fantastic end goal. Take it slowly if that’s all you can afford. Small steps all add up on a long journey.
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