Medicaid coverage for tubal reversal

I’m on MaineCare and would like to reverse my tubal ligation.  Will they pay for the surgery?

Wants One More Baby

Dear Wants One More Baby,

Medicaid will pay only for medically necessary care.   A tubal ligation reversal is not considered medically necessary for the patient’s health and wellbeing.   Therefore, it would generally not be covered.  I say generally, because there may be a case where the surgery is necessary.  This might be the case if the original ligation surgery was botched or you had some other unusual circumstance.

Having more children is not going to be considered a medical reason.  (Lots of people might consider their children a hazard to their health or sanity, rather than a boost . . . but I digress.)

Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.