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Does Medicaid pay for tubal reversal?

By Sophia Koch |

Can you get your tubes untied with Medicaid? Yes, as a Medicaid recipient, you can undergo tubal ligation reversal surgery – but will probably have to pay for the procedure yourself unless you have a medically necessary reason.

How expensive is a tubal reversal?

The surgery can cost more than $10,000. The cost is not covered by most provincial health plans or private health insurance plans. There is no guarantee that you will be able to become pregnant after having the reversal.

Can your tubes become untied naturally?

You have a common misconception. Your tubes are not actually tied together; they’re each cut or clipped to prevent an egg from being fertilized. Gaining weight won’t cause the “knot” to come undone.

What type of tubal ligation is not reversible?

Some forms of sterilization are difficult or impossible to reverse: Salpingectomy. If you had this procedure, your tubes were totally removed – your only option is IVF. Essure or Adiana sterilizations are also not reversible and these patients need to undergo IVF.

How can I get pregnant without tubal reversal?

You may want to consider in vitro fertilization (IVF). In this procedure, your egg and a man’s sperm are fertilized outside the womb in a laboratory dish. The fertilized egg (embryo) is later placed into your womb. IVF is also an option if you don’t get pregnant after tubal reversal surgery.

Do you need insurance for tubal reversal surgery?

Some insurance companies do provide coverage for tubal reversal surgery. To find out if you will be reimbursed for this procedure you will need to provide your insurance carrier with the diagnosis and procedure codes.

Can you get a tubal ligation reversal with Medicaid?

In general, Medicaid will not pay for tubal reversal surgery in any state unless you can cite a medically necessary reason. Therefore, getting your tubes untied with Medicaid may mean finding alternatives. Lower your costs. Find free services.

Can a health insurance company pay for a tubal ligation?

Most health insurances will not pay for non-essential surgery. They will not pay for breast augmentations, face lifts, tummy tucks, etc. They feel the same about paying for infertility treatment if you have had a voluntary tubal ligation procedure.

Do you have to have BCBS to get tubal reversal?

BCBS covers tubal reversal following the same rules already noted. They might pay for medically necessary procedures – otherwise, the answer is typically no. Also, they sometimes use trade names, adding a layer of confusion.