The cheapest tubal ligation reversal is given to patients who get their health insurance (or medicaid) to pay for some or all of the surgical steps.
However, you must show that you have a valid medical reason before insurance will cover any part of the procedure, which is difficult to prove.
Fortunately, there are other avenues that make getting your tubes untied more affordable.
Follow along as we illustrate three money-saving options that solve tubal reversal for less than $5,000, $4,000 and $3,000 net out-of-pocket of other related considerations, factors that many people can easily overlook.
At an average cost of $8,500, the reductions could have a big impact.
make tubal reversal more affordable
three-way can make your tubal ligation reversal surgery more affordable, even when insurance doesn’t cover any of the costs, which is most common (see below in the next section).
less than $5000
On the first track, free tubal reversal grants could push your costs below $5,000, but not much more. Grants are money provided by another person or organization that you do not have to pay back.
The federal government does not award grants to individuals for personal use, so opportunities are rare. Instead, you may need to seek out charities that rely on the generosity of donors. they often have limited resources and are able to offer assistance to only a handful of couples each year.
less than $4000
On the second track, a flexible spending account (fsa) can bring your net tubal reversal costs below $4,000 while offering an added benefit you probably never considered.
fsa-enabled tubal reversal payment plans save you money at the same time. Your employer must reimburse any eligible expenses immediately, which means you could have up to 52 weeks to pay off an interest-free loan while you reduce the amount of income subject to tax.
The 2022 fsa contribution limit is $5,700 for a married couple. Suppose a fictional duo has an adjusted gross income of $100,000 and works in California. using pre-tax money to pay for surgery generates these savings.
In this example, a couple can use fsa to get surgery for less than $4,000 ($3,500 to be exact) while paying the surgeon up to $5,700 in pre-tax dollars, if they can find a willing low-cost doctor. to charge this cost. price.
Of course, the savings vary depending on the income tax rates in the state where you work and whether they recognize pre-tax payroll deductions.
less than $3000
In the third way, a health savings account (hsa) could reduce tubal reversal costs to less than $3,000, provided you know the secret to unlocking the extra savings. An HSA is a tax-advantaged account connected to a High Deductible Health Insurance Plan (HDHP).
The hidden feature of an HSA is that as long as you set up an account before you incur a qualifying expense, you can pay for it later using tax-advantaged dollars, as long as you continue with an HDHP.
In other words, annual contribution limits don’t restrict your savings.
- individual: $3650
- family: $7300
In this illustration, our example couple can use an HSA to reduce the costs of the surgery to less than $3,000 while paying the surgeon up to $7,702 in pre-tax dollars; If you can find a low-cost doctor, find one willing to charge this price.
so how much will it cost to untie your tubes using an hsa? follow the math ($3,000/38.95% = $7,702), trading in your possibly higher proceeding price and marginal tax rates.
how to get insurance that covers tubal reversal
How can you get health insurance to pay for tubal ligation reversal surgery and bring your costs below $4,000 or $3,000? Unfortunately, all plans exclude prior voluntary sterilization from coverage unless you have a qualifying medical reason.
Fortunately, women have two ways to prove a valid medical reason and obtain coverage. focus on these two viable affordable options while avoiding dead ends that lead you nowhere.
Having a qualifying medical reason for tubal reversal surgery is the only way to get health insurance to pay claims. however, your coverage options are much better for the intended result than the procedure.
You are more likely to get insurance that will pay for the expected result of your tubal reversal. your future pregnancy and childbirth are qualifying medical reasons with no exclusions for prior voluntary sterilization.
Supplemental health insurance covers the results of infertility. however, you must purchase coverage before you conceive to avoid the pre-existing pregnancy exclusion.
- short-term disability replaces a portion of earnings during maternity leave
- hospital indemnity insurance pays a cash benefit for normal labor and delivery
You are less likely to get insurance to pay for tubal reversal surgery because the qualifying criteria are strict. You must establish a valid medical reason for the procedure: to prevent, diagnose, or treat an injury, illness, or symptom.
Work with your surgeon to draft a letter of medical necessity and submit the document to the issuing company for prior authorization. some of these details could be the solution.
- preoperative blood tests to detect infections (stds, hiv or hepatitis)
- ultrasound and exam to visualize the health of the reproductive organs
- post tubal ligation syndrome (ptls) is the rapid decline in estrogen/progesterone hormone levels caused by impaired blood supply to the ovaries
- dysmenorrhea is pain and cramps during the menstrual cycle
- damage to nearby organs
- reactions to anesthesia
can you untie your tubes with medicaid? As a Medicaid recipient, you can have tubal ligation reversal surgery, but you’ll likely have to pay for the procedure yourself.
Medicaid covers tubal reversal when medically necessary, following the same parameters used by private insurance companies. work with your surgeon to document a valid medical reason (see above).
Medicaid for pregnancy pays for tubal ligation but rarely reversal because infertile women file fewer claims than those with natural and restored fertility. be careful with this dead end.
Also, don’t allow the many established Medicaid brands in some states. the same rules apply to these alternative name organizations.
Looking for insurance companies that cover tubal reversal surgery is a poor strategy for finding a plan that will pay for the procedure. With confusing topics, we sometimes ask the wrong questions and hit dead ends.
The rare qualifying medical reason (see above), not the issuing company, determines whether tubal reversal is covered by insurance. inquiries about the organization will get you nowhere.
blue cross blue shield
for example, asking if blue cross blue shield (bcbs) covers tubal reversal will not answer if your plan will pay for the procedure. it’s another dead end.
Submitting a letter of medical necessity in collaboration with your surgeon (see above) is the best way to get your bcbs plan to pay for your tubal reversal.
blue cross blue shield is a national federation of thirty-five independently owned and operated insurance companies, each of which sets its own claims underwriting standards. furthermore, the many connected trade names cause confusion.
Similarly, asking if tubal reversal is covered by Aetna, Cigna, Kaiser Permanente, or United Healthcare is another dead end. each of these companies will follow similar claims underwriting standards.
You must establish a valid medical reason (see above) before Aetna, Cigna, Kaiser Permanente, or United Healthcare will accept your surgery claims.
In addition, each state could choose Aetna, Cigna, BCBS, Kaiser Permanente, or United Healthcare to act as Managed Care Organizations (MCOs) for Medicaid. don’t let this confusing overlap lead you astray. stick with the basics.
ivf after ligation
Will insurance cover IVF after tubal ligation? You go down another dead end street. For at least two reasons, no health plan will pay for in vitro fertilization after a voluntary sterilization procedure.
- IVF is rarely covered by health insurance because the procedure is not medically necessary (services needed to diagnose or treat an illness, injury, condition, or its symptoms)
- all state IVF insurance mandates specifically exclude coverage when prior voluntary sterilization causes the underlying infertility
So, cross IVF insurance after tubal ligation off your list of alternatives that could make getting pregnant more affordable. scroll back to see how grants, flexible spending accounts, and health savings accounts can lower your expenses.
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