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Does Health Insurance Pay For Essure Reversal?

As a specialty center for Essure reversal, our office staff are frequently asked “Does health insurance pay for Essure reversal?”

does-health-insurance-pay-for-essure-reversalEssure was first approved in 2001. At first, not many women opted to have the Essure procedure. Very few Essure procedures were performed.

After the Bayer Health Care Corporation acquired Essure in 2013, more aggressive marketing of Essure occurred, more doctors began offering Essure, and more women opted to use Essure for permanent birth control (sterilization).

It has been estimated that over 750,000 women world-wide have had Essure. The actual numbers of women who have Essure inserted is probably way higher than the often repeated number of 750,000.

Essure sterilization is intended to be permanent. Prior research has shown a significant number of women will regret their sterilization procedure. Some women will consider in-vitro fertilization (IVF) and some will consider surgical reversal of sterilization.

These women will approach their doctors and ask does health insurance pay for Essure reversal or IVF? Unfortunately, health insurance will not pay for either of these treatments.

To better understand why health insurance will not pay for Essure reversal you should understand how health insurance companies look at tubal ligation reversal surgery.

Does health insurance pay for tubal ligation reversal?

Over 98% of health insurance companies will not pay for tubal ligation reversal.

The first tubal ligation was performed in 1880’s and since then millions of tubal ligation procedures have been performed. The first tubal reversal surgery was performed in the 1960’s. As tubal reversal surgery became a more common, health insurance companies quickly realized tubal reversal was being done for fertility reasons.

In an effort to keep costs down, health insurance companies decided tubal reversal was not medically required.

Health insurance companies have a long history of dealing with request for payment for reversal surgery and have no problem telling their members “tubal reversal is a non-covered procedure”.

Does Health insurance Pay For Essure Reversal?

Essure reversal is a procedure to remove the Essure devices and reopen the fallopian tubes. The purpose of Essure reversal is to restore the natural function of the fallopian tube and allow for natural conception and pregnancy.

More information: Tubouterine implantation for Essure reversal

Health insurance companies consider Essure reversal and IVF as fertility treatments.
These treatments are considered non-urgent and not required to improve the health or life of a person. Health insurance companies look at the Essure reversal procedure the same way they look at tubal reversal surgery, face lifts or breast augmentation procedures.

Fertility is considered non-urgent, not necessary, and not worthy of wasting health care dollars.

Does health insurance pay for Essure reversal? Our experience

In our experience, we have observed some health insurance companies will pay for Essure reversal and some will not. It really is a toss up.

Health insurance companies are seeing a large increase in submitted claims for treatment of Essure complications.

Health insurance companies will readily pay for Essure removal if you are having a complication from Essure. Unfortunately they will only pay for Essure removal if the surgery is done in a hospital and if you have a hysterectomy (complete removal of the uterus) or salpingectomy (complete removal of the Fallopian tubes).

Health insurance will pay for Essure removal but not for Essure reversal.

Will health insurance pay for Essure reversal with Dr. Monteith?

health-insurance-rarely-pays-for-essure-reversalDr. Monteith is a participating member in Blue Cross Blue Shield, Cigna, and Aetna. Some of his Essure reversal and Essure removal patients are seeing partial reimbursement for Essure related surgery at A Personal Choice.

For more information: Will health insurance pay for Essure reversal or Essure removal at A Personal Choice?

Often if your health insurance company covers Essure removal….they are more willing to cover the procedure if the procedure is done in a hospital setting.

Often your health insurance plan will is more likely to cover complete hysterectomy or fallopian tube removal. When you have Essure removal outside of a hospital or Essure reversal then reimbursement is more likely to be partial reimbursement, if you see any reimbursement at all.

Need More Information About Tubal Reversal?

A Personal Choice Tubal Reversal Center is in Raleigh, North Carolina and specializes in tubal ligation, Essure, and vasectomy reversal surgery.

Dr. Monteith specializes in helping couples have more beautiful children with reversal surgery and helping women treat abnormal symptoms after their tubes have been tied!

If you would like more information about reversal, including the cost and success rates, then enter your email address below and you will be emailed more information about reversal.

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Join Our Facebook Group?

Women who need more advice about reversal are encouraged to join A Personal Choice’s public Facebook group:

Facebook Tubal Reversal Group of A Personal Choice

By joining the group you can communicate with other women who have had successfully reversed their tubal ligation and restored their natural fertility.

Have Questions? Leave a comment here or visit our contact page.


Anonymous Reply

I had the essure birth control method done in March 2012. I regret I got it did because I want another baby. I know 45 might seem to old to be having another baby but my significant other only has 1 child and he wants another one and I’m not able to give him one. I cry sometimes because I really want to have a baby with him.I can’t afford to pay all that money to have it reversed. Sometimes I just pray that I get pregnant with the essure method

    Dr. Monteith Reply

    It is harder to become pregnant with increasing age but not impossible if you are having periods. If you want to become pregnant you heave two choices: IVF or Essure reversal.

    If you go for IVF they will require you to use donor eggs after age 42. The cost will be between $15,000 to $20,000.

    If you have Essure reversal you will have a chance of pregnancy every month. At age 45 the chance of pregnancy is less than 10%. If you want to become pregnant don’t delay your decision for too long because each year you lose 12 chances and each year the chances become less.

    We specialize in Essure reversal and Essure removal surgery. We can reverse Essure and give you the chance of pregnancy….or we can remove Essure and leave your tubes closed. The chance of pregnancy after Essure reversal is about 40%.

    More information: Essure reversal testimonials

    If you would like to see if you are a candidate for Essure reversal, your first step would be to send us your records from your Essure insertion procedure and the results of your 3 month follow up x-ray.

    The cost for the Essure reversal procedure and the Essure removal procedure is the same… $7,900. We are located in Raleigh, North Carolina.

    No other clinic or doctor has the experience we do. The chance of pregnancy after Essure reversal is about 40%. If you are having symptoms that started soon after Essure most patients report improvement after removal of the devices. We do have a surgery prepayment plan.

    More information: Successful Essure reversal with Dr Monteith

    We charge a total of $7,900 for Essure reversal/removal plus $150 to schedule surgery. If you use our prepayment plan then you can contribute any amount as you are able but you must have the surgery paid for by three years. We do work with two financing companies and we do have a prepayment plan.

    The following link will answer most of your questions about reversal. This is the MOST HELPFUL INFORMATION to read when considering reversal at our office. Each question has a link to more information about the question: Frequently asked questions about tubal reversal

    Call us at (919) 977-5050 8am to 5pm eastern standard time and we would be happy to speak with you about tubal reversal at our facility.


I am with blue across Mississippi . i tried everything and i wanted to get pregnancy. i have a tubal ligament but i want a REVERSAL and my insurance is not covering it what do i do.

please help i do not knw what to do now

    Dr. Monteith Reply

    We should be able to help you. We can reverse most tubal ligation procedures.

    The first step to see if you are a candidate is to send us your tubal ligation reports to us for a free review and we can let you know if you are a candidate for reversal surgery.

    Your reports can be obtained from the medical records department where your tubal ligation surgery was performed.

    We charge $6,900 total plus $150 to schedule and we are located in Raleigh, North Carolina.

    Patients pay in full and out-of-pocket at the time of scheduling. All you have to pay for in addition to the surgical fee is the cost of travel, hotel, and food.

    On average the chance of pregnancy after tubal ligation reversal is about 60% if you are under age 42.

    We do have a prepayment tubal reversal plan that allows you to save towards your reversal over a 3 year period.

    Although $6,900 seems expensive…the alternative treatment in-vitro fertilization (IVF) average $12,000 to $14,000 and is about 40% successful!

    The main advantage to tubal reversal is that every month you have a chance and you can become pregnant more than once.

    The following link will answer most of your questions about reversal. This is the MOST HELPFUL INFORMATION to read when considering reversal at our office. Each question has a link to more information about the question:

    Frequently asked questions about tubal reversal

    Call us at (919) 977-5050 8am to 5pm eastern standard time and we would be happy to speak with you about tubal reversal at our facility.

Have Questions? We’re Happy To Help!

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