What Insurance Covers Tubal Reversal - T-Tees - Your Answers Await, Life's Questions Unraveled

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This is a continuing blog series that addresses erroneous ‘facts’ listed by a in-vitro fertilization (IVF) expert.

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The list of biased ‘facts’ against tubal reversal was intended to persuade women to have IVF rather than tubal reversal.

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Unfortunately many women who discuss tubal reversal with their doctors will hear many of these same biased opinions.

The complete list of biased ‘facts’ against tubal reversal can be seen in the first article in this series is So Called ‘Facts’ About Ligation Tubal Reversal.

This article deals with the third biased ‘fact’ listed by the IVF specialist: Tubal reversal is not paid for by health insurance and there is no guarantee that tubal reversal will work.

Will Insurance Pay For Tubal Reversal?

Unfortunately the vast majority of health insurances will indeed not pay for tubal reversal. Neither will Medicaid nor Medicare pay for reversing tubes either. Occasionally a patient will have a unique health insurance plan which will pay for either part or all of tubal reversal. These generous insurance plans are very rare.

Some military insurances will pay for tubal reversal; however, there are often so many restrictions on who can do it and what must be done in order to have the surgery that it becomes very impractical to have military insurance pay for tubal reversal surgery. Most of these patients will end up paying out of pocket rather than waiting several years to get a tubal reversal through the military.

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Tubal Ligation Side Effects: Will Insurance Pay?

If you have pain, heavy periods, loss of sex drive, or any of the other side-effects women occasionally report after getting their tubes tied then I am also sorry to inform you health insurance will not pay for a tubal reversal surgery and neither will Medicaid nor Medicare. Sorry but it ain’t gonna happen no matter how hard you try to make it happen.

Some patients will get an uninformed, representative who will initially tell them over the phone their plan will pay for tubal reversal if there is a medical indication for the surgery; however, they won’t tell you it is very difficult to get a doctor to agree with this concept.

They also will not tell you when it is all said and done, your claim gets to upper level management, and it comes down to actually paying for surgery then they will deny payment.

They will never admit their representative gave you the wrong information and they will just tell you they don’t pay for infertility treatments. We have seen this many times before.

Will Insurance Pay For IVF?

I have depressing news for you. The vast majority of plans will not pay for IVF. Some will pay for IVF but will not do it if you have had a voluntary 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.

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What if you were coerced into tubal ligation? Often they won’t buy this excuse and the health insurance folks think it is more appropriate for your lawyer to work this one out for you in the medical malpractice courts.

If you have had your tubes tied then you are often on your own when it comes to paying for either tubal reversal or IVF.

Is Tubal Reversal Guaranteed To Work?

There are no guarantees when it comes to any infertility treatment. This is true regarding IVF and tubal reversal.

On average most women will have tubal reversal pregnancy success . Approximately 60% will report pregnancy within one year and approximately 33% will have a baby within one year. Regarding IVF pregnancy success, approximately 30% of patients will become pregnant with each cycle of IVF attempted.

Facts On Tubal Reversal

I have been evaluating the IVF doctor’s biased statements about tubal reversal. Most are heavily biased against tubal reversal and about half are incorrect.

Since my elementary school daughters are good at distinguishing fact from opinion I have been enlisting their assistance in the grading of each of the IVF expert’s biased statements against reversal.

Health insurance will not pay for tubal reversal (fact) and there is no guarantee tubal reversal surgery will work (fact).

The IVF expert did pretty good on this one but the IVF expert neglects to mention the exact same facts are also true for IVF.

The next article in this series deals with the IVF experts fourth biased opinion:Checking For Blocked Tubes After Tubal Reversal.

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Submitted by Dr. Charles Monteith

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