Tubal Reversal Insurance

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.