Will medicare pay for reversal tubaligation?

Answer 1

It depends on the policy and what was specifically covered in the terms of the contract, but generally, most policies will not cover a tubal reversal. The tubal was, in the first place, a deliberate action in an effort to prevent a medical condition; yes, pregnancy is a medical condition. By the standards of most insurance companies, it will be effectively impossible to get them to cover reversal of a tubal ligation.

The main issue in determining coverage is whether the procedure is "medically necessary". If it is, according to a physician, there is a better chance of coverage than if it is elective.

Answer 2

It depends mainly upon the terms of your policy, which is why you must read it carefully. Specifically, read the section entitled "Exclusions" to determine if tubal ligation reversal is expressly excluded from coverage. Some companies may consider this to be elective surgery (which is generally excluded), because a non-medically necessary decision may have been made to have the sterilization done initially.Still other insurers may cover part of the procedure, such as testing and anesthesia.

Some companies may cover the whole procedure. Factors involved include what the policy expressly states, the legal requirements of the state in which the policy was issued or in which you live (some require coverage for fertility treatment, so perhaps an argument could be made for this).

Do not downplay the utility of good communication with the insurer and the assigned claims representative. Contrary to popular belief, they are human and may be inclined, given politeness, reason, and a valid argument, to work with you.

Answer 3

Depends on ur insurance carrier! Blue cross Blue shield of Illinois ppo does... all that is needed is a 250.00 deductible! If your employer provides this insurance, chances are you are covered...if you are a male and your partner is having a TR(tubal reversal) it wont cover unless you are married! Personal Experience!

Answer 4

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Answer 5

Some do, some don't. Contact your plan to find out if you are covered and congratulations on your decision.

Answer 6

No. Tubal reversal sugery is considered an elective and/or infertillity treament. Most insurances will not cover either.