Tubal Reversal Under $3,000: Health Insurance Or HSA?

Getting tubal reversal under $3,000 near you is possible without finding a local surgeon willing to perform the procedure at this meager price.

The secret is finding ways to get a deep-pocket third party to pick up most of your costs.

Getting your health insurance to cover tubal reversal is one strategy with low success odds, as most women will not meet the strict criteria.

Fortunately, other avenues make getting your tubes untied more affordable. You might find grants to defray costs and whittle them down further by using pre-tax money to pay for the procedure.

Affordable Tubal Reversal Near You

Finding a way to get the cheapest tubal reversal near you is more affordable than traveling out of the country for surgery. The costs of flights, hotels, and meals add up quickly.

Fortunately, you can combine two strategies to reduce the average cost of $8,500 to a more manageable number without traveling.

Under $4,000

Grants might help you get tubal reversal under $4,000 near you without traveling abroad. Grants are money another person or organization provides that you do not have to repay.

Free tubal reversal near you is probably an unrealistic expectation. Still, charitable foundations and other organizations might provide enough assistance to lower your costs from $8,500 to below $4,000 – if you can find a well-funded program and meet the qualifying criteria.   

Under $3,000

For cheaper surgery, three additional programs combine to get tubal reversal under $3,000 near you without traveling long distances. In this step, we use the grant-enabled $4,000 figure as our starting point before lowering costs further using pre-tax money.

Financing

Payment plans for tubal reversal are the first program sometimes needed to get costs below $3,000 for couples who do not have $4,000 in the bank. The third-party finance company pays the surgeon upfront and later bills you monthly.

Financing spreads the costs over time, allowing you to match the installments with the savings, making the process more affordable.

HDHP

A High-Deductible Health Plan (HDHP) is the second program needed to get tubal reversal costs below $3,000. An HDHP is a crucial step in the process, even though the insurance probably will not cover the surgery (see below).

Apply for an HDHP during open enrollment on healthcare.gov or through your employer if they offer health insurance.

HSA

A Health Savings Account (HSA) is the third program needed to achieve tubal reversal below $3,000. An HSA is a tax-favored medical savings account for people enrolled in an HDHP.

Contribute pre-tax money to your HSA up to the annual limit. If affected by the yearly maximum, you can reimburse yourself in the future, provided you remain enrolled in an HDHP.

For example, a couple living in California with $100,000 in Adjusted Gross Income (AGI) could use an HSA to reduce a $4,000 surgery cost to $2,442 net of taxes.

RateSavings
Federal22.00%$880
FICA7.65%$306
State9.30%$372
   
Total38.95%$1,558

State

Of course, the state where you work influences the impact an HSA might have in getting your tubal reversal costs below $3,000.

The income tax rates vary by state, affecting the amount saved by paying for the surgery with pre-tax money.

No TaxHighest Rates
WyomingCalifornia: 13.3%
WashingtonHawaii: 11%
TexasNew Jersey: 10.75%
South DakotaOregon: 9.9%
NevadaMinnesota: 9.85
FloridaNew York: 8.82%
AlaskaWisconsin: 7.65

How to Get Insurance to Cover Tubal Reversal

Getting health insurance to cover tubal reversal can lower costs below $3,000 near you. However, most women will fail in this quest because only a tiny fraction will have a medically necessary reason.

Fortunately, you could use insurance (or a high-deductible plan) in other ways to make getting pregnant more affordable without having to travel outside the country.

Medical Reasons

Establishing a valid medical reason is the only way to get health insurance to pay for tubal reversal surgery. The procedure must prevent, diagnose, or treat an injury, disease, or symptoms.

Follow this sample letter of medical necessity to make your case in collaboration with the surgeon. Submit the document to the insurance company for preauthorization. Some of these details might do the trick.

  • Testing
    • Pre-operative bloodwork to spot infections (STD, HIV, or Hepatitis)
    • Ultrasound and exam to visualize the health of reproductive organs
  • Surgery
    • Post Tubal Ligation Syndrome (PTLS) is the rapid decline of estrogen/progesterone hormone levels caused by damaged blood supplies to the ovaries
    • Dysmenorrhea is pain and cramping during your menstrual cycle
  • Recovery
    • Bleeding
    • Infection
    • Damage to nearby organs
    • Reactions to anesthesia

Medical Outcome

Buying supplemental coverage is the ideal way to get insurance to pay for the intended tubal reversal outcome. Your future pregnancy and childbirth are qualifying medical reasons with no exclusions for previous voluntary sterilization.

Supplemental health insurance covers infertility outcomes. However, you must purchase the coverage before conception to avoid exclusion for preexisting pregnancy.

IVF After Tubal Ligation

Health insurance never covers IVF after tubal ligation, making this alternative treatment a poor strategy to lower your costs of bringing home a newborn.

Health insurance pays for IVF when required by state law. However, every mandate excludes coverage to reverse previous voluntary sterilizations.

Therefore, remove insurance for IVF after tubal ligation from your list of alternatives that might make getting pregnant more affordable.

What Insurance Covers Tubal Reversal

Asking what health insurance company covers tubal reversal is another poor strategy for lowering costs below $3,000. Queries about the organization lead you nowhere.

Scroll back to the top to learn how grants and Health Savings Accounts might reduce your spending

Medicaid

You can get your tubes untied with Medicaid but do not expect this public health insurance program to cover the surgery.  

A valid medical reason for tubal reversal might qualify for Medicaid coverage. Collaborate with your surgeon to compose a letter of necessity and submit it to the Managed Care Organization (MCO) that administers the plan in your state.

Medicaid Pregnancy

You can get your tubes untied with Medicaid and expect the public health insurance program to cover the intended outcome: your pregnancy.

Medicaid covers pregnancy ultrasound and related expenses such as prenatal care, labor, and delivery. Just do not count on any help with the surgery needed to restore your fertility.

Medicaid Nicknames

You can get your tubes untied with Medicaid but do not expect the coverage rules to vary based on the confusing nicknames states use to brand their programs.

You need a valid medical reason before any of these Medicaid brands will chip in towards the cost of your procedure.

StateMedicaid Name
AlabamaAL Integrated Care Network
ArizonaAZ Healthcare Cost Containment System (AHCCCS)
CaliforniaMedi-Cal
ColoradoHealth First Colorado
FloridaMy Florida Families
GeorgiaGeorgia Families
IllinoisIllinois Family Care
KentuckyKentucky Health Choices
LouisianaHealthy Louisiana
MassachusettsMass Health
MichiganMI HealthCard
New YorkNYS Medicaid
New JerseyNJ Family Care
North CarolinaHealth Choice
OklahomaSoonercare
PennsylvaniaHealth Choices
TennesseeTenncare
TexasTexas Medicaid & STAR
VirginiaVirginia Medicaid
WisconsinBadgerCare

Blue Cross

Asking if Blue Cross Blue Shield (BCBS) covers tubal reversal will not answer whether your plan will pay for the procedure. It is another dead end.

Submitting a letter of medical necessity in collaboration with your surgeon is the only way to get your BCBS plan to pay to reverse a previous tubal ligation.

 Blue Cross Blue Shield is a federation of thirty-five independently owned and operated insurance companies, often using unique tradenames.

BCBS StateTradename
FloridaFlorida Blue
GeorgiaBCBS GA
IllinoisBlue Shield Illinois
KentuckyAnthem
New JerseyHorizon
New YorkAnthem
North CarolinaBCBS NC
OklahomaBCBS OK
PennsylvaniaCapital & Highmark
UtahRegence
VirginiaAnthem
WisconsinAnthem