Does Medicaid Cover Tubal Ligation Reversal? IVF, Costs, Options

No, Medicaid does not cover tubal ligation reversal. Every state Medicaid program treats the surgery as elective, and no federal rule requires coverage. Patients paying cash face an average of about $8,500, with a national range of roughly $5,000 to $21,000.¹²

Why Medicaid Treats Reversal as Excluded

The federal regulations that govern Medicaid-funded sterilization, at 42 CFR Part 441 Subpart F, define the procedure as one meant to render a person “permanently incapable of reproducing.”³ The required federal consent form says plainly: “I understand that the sterilization must be considered permanent and not reversible.”⁴ Because the framework treats the original surgery as a one-way event, a reversal does not fit the service Medicaid funds, and no separate federal mandate requires states to pay for it as fertility care.

States have made the exclusion explicit. Mississippi’s Medicaid administrative code lists “reversal of sterilization” and “reversal of voluntary sterilization” as non-covered under both the state plan and the family planning waiver.⁵ North Carolina’s Medicaid clinical policy, reviewed in January 2026, states that the program “shall not cover procedures for the reversal of sterilization,” naming both tubal reversal and vasectomy reversal.⁶

Does Medicaid Cover IVF Instead?

Generally no. No state Medicaid program covers in vitro fertilization as a general benefit. As of 2026, only three jurisdictions offer any Medicaid infertility coverage at all, and each is narrow:⁷

New York and Washington, D.C. cover up to three cycles of ovulation-inducing medications.⁸
Utah covers IVF and genetic testing, but only for Medicaid enrollees who carry one of five specific genetic diseases, such as cystic fibrosis or sickle cell anemia.⁸

Illinois, Maryland, Montana, Oklahoma, and Utah require Medicaid to cover fertility preservation for patients facing treatment-induced infertility, such as those undergoing chemotherapy. None of these provisions help a person who chose sterilization and later changed her mind.⁹ A 2025 Connecticut bill that would have required Medicaid to cover fertility diagnostics and ovulation-enhancing drugs died in committee, and no pending federal or state proposal would require Medicaid to cover reversal itself.¹⁰

Other Coverage Paths Worth Checking

Private insurance is only marginally more helpful. Most plans classify tubal reversal as elective, and even plans that cover some fertility care typically exclude cases involving a prior voluntary sterilization.¹¹ Coverage sometimes becomes possible when a physician can document medical necessity tied to complications from the original surgery, such as chronic pelvic pain or post-tubal ligation syndrome. That route requires a letter of medical necessity and prior authorization, and approval is not guaranteed.¹²

Government health programs vary:

The Department of Veterans Affairs covers consultation for sterilization reversal for all enrolled veterans, regardless of service connection or marital status, and lists tubal ligation reversal among its surgical services.¹³¹⁴
TRICARE sends mixed signals. One official TRICARE page says reversal “may” be covered if medically necessary due to a disease or injury. A separate reproductive health page updated in August 2025 lists sterilization reversals as “not covered.” Elective reversal is likely excluded in practice, with any coverage limited to cases tied to a diagnosed disease or injury.¹⁵¹⁶

What the Procedure Costs and How People Pay

Out-of-pocket costs run from about $5,000 to $21,000, with a national average near $8,500.¹ A typical quote covers the surgeon’s fee, anesthesia, facility charges, and basic follow-up. Travel, lodging, and pre-operative testing can push the total higher. Some high-volume clinics offer all-inclusive packages at the lower end of the range, and a few advertise prices under $5,000.²

Because almost everyone pays cash, financing options have grown up around the procedure. Healthcare credit cards such as CareCredit sometimes offer interest-free promotional periods of six to 24 months. Clinics commonly run their own payment plans with down payments of $1,000 to $2,000 and installments spread over six to 24 months. Third-party medical lenders like Prosper Healthcare Lending and CapexMD also finance the surgery.¹⁷ Tubal reversal generally qualifies as an eligible expense under Health Savings Accounts and Flexible Spending Accounts, since it falls within the medical expenses deductible under IRS Section 213(d).¹⁸

Reversal or IVF When You’re Paying Yourself

With neither option typically covered, the clinical tradeoff matters. For women under about 37, tubal reversal tends to be more cost-effective. A 2015 cost-effectiveness analysis in Fertility and Sterility put the cost per ongoing pregnancy for reversal at roughly $16,000 to $223,000, compared with $33,000 to $112,000 for IVF, with reversal winning on cost for women under 41.¹⁹ Cumulative pregnancy rates for younger women after reversal can reach 70 percent within 18 months.²⁰ IVF offers higher per-cycle success rates of 35 to 40 percent for women under 35, and a faster timeline, with most cases completed within a year.²¹

For women over 37, most fertility specialists recommend IVF. Reversal success rates drop with age, ectopic pregnancy risk rises to 10 to 20 percent of post-reversal pregnancies, and the longer time to conception costs fertile years.²¹ By age 42 or 43, success rates for both approaches fall below three percent.²⁰

1
Healthline. Tubal Ligation Reversal
2
CNY Fertility. Tubal Ligation Reversal Cost
3
eCFR. 42 CFR Part 441 Subpart F – Sterilizations
4
Cornell Law Institute. Appendix to Subpart F of Part 441
5
Mississippi Division of Medicaid. Administrative Code Part 221
6
WellCare of North Carolina. Clinical Policy WNC.CP.226 – Sterilization
7
Multistate. State Fertility Coverage Mandates Expand in 2026 Legislative Sessions
8
RESOLVE. Medicaid Coverage for Infertility Treatments and Fertility Preservation
9
National Women’s Law Center. The Importance of Equitable Access to Fertility Care for Black Women
10
BillTrack50. CT HB07022 – Promoting Equity in Medicaid Coverage for Fertility Health Care
11
My Fertility Center. Tubal Ligation Reversal – What You Should Know Before Surgery
12
Reproductive Fertility Center. Will My Health Insurance Pay for Tubal Ligation Reversal
13
VA Women’s Health. Fertility Services
14
VA News. VA Infertility Services Can Help Veterans and Their Families
15
TRICARE. Surgical Sterilization
16
TRICARE. Reproductive Health
17
Doctor Neef. Financing Robotic Tubal Reversal
18
St. Luke’s Hospital Duluth. HSA Eligible Expense List
19
PubMed. Cost-Effectiveness of Tubal Anastomosis Versus IVF
20
ARC Fertility. Tubal Reversal Versus IVF – Best Choice
21
Shady Grove Fertility. Tubal Reversal vs IVF