Frankly, it is important to evaluate the worst that would happen if they somehow found out. Would the relationship simply become tense or uncomfortable? Or would you be risking material harm (being thrown out, violence, disownment, etc.)?

Guide: How to get sterilized while on a parent’s insurance plan

General: Insurance Coverage for Sterilization

Here is our article on insurance coverage for sterilization in the US. Because most sterilization procedures are covered at 100% under the ACA, your parents will not have to pay a cent! But you individually should be be prepared to pay any smaller fees that are not covered. (It happens occasionally - I had to pay about $200 in hospital fees that were not covered by my insurance.)

General information: Bedsider’s guide on how to get privacy on your parents’ insurance - applies to sexual health in general.

Specific Guidelines

1. Get an insurance card

Your parent (the plan subscriber) should be able to order a card for every insured family member on the plan.

You can say that you need the card in case of emergency (which is true - you should be carrying it with you just in case) or for a regular annual checkup.

2. Find a doctor

If you don’t already have a doctor who is a gynecologist and a surgeon, find a doctor.

Make sure your chosen doctor is in your health insurance network. Use the tool on your insurance company’s website to check. If no tool is available, call your insurance company using the number on the back of your card and ask if the specific doctor is in-network.

Some insurance plans require you to get a referral from a family doctor/GP/primary care provider (PCP) before you can see an OB/GYN specialist. In general, most PPO plans don’t require this and even many HMOs now consider gynos to be primary care providers (PCPs). Check with your insurance plan.

If they require a referral, then you need to get a referral from either your regular family doctor or a family doctor off the childfree-friendly lists. (You may keep the reason for the referral generic, such as “to discuss birth control options”, if you don’t want the GP to know that you’re seeking sterilization.)

3. Make an appointment

Call the doctor’s office and make the appointment for your sterilization consult. (When I called to make my appointment, I asked “Would Dr. X consider permanent sterilization on a 23 year old with no children?” It’s not foolproof, but if the receptionist is taken aback, it’s probably not a good sign.)

If it’s a doctor you already see, you have the option of bringing it up at a regular appointment.

4. After your appointment

After your appointment, your doctor’s office will bill your insurance company.

If your parents access the insurer’s website, they’ll likely be able to see the reason for your appointment, but that reason is usually generic: “annual physical” or “consultation for contraceptive options”. It’s very unlikely to say “sterilization consult” because there is no billing code specifically for that; it’s for contraceptive consult in general. The Explanation of Benefits (EOB) statement will have a code that corresponds to the reason for the appointment, so it will also be generic.

If you book your appointment as an annual, like I did, then it’ll be billed as an annual checkup. Your parent will have no way of knowing sterilization (or even contraception) was discussed at the appointment.

4b. Subsequent appointments

If you have subsequent consultations other than the pre-op appointment, they will also be billed under a “consultation for contraceptive options” code. (You can’t have more than one annual physical per year.)

Same applies if you’re turned down and need to see more than one doctor to get approved.

5. The surgery

A few days (usually up to a week) before surgery, you’ll have a pre-operative appointment to make sure everything is good to go. For the purposes of insurance billing, the pre-op appointment is considered part of the surgery, so it won’t be billed directly.

On the day of the surgery, find a non-family member to drive you. (If you need your parents to drive you, it’ll be more challenging. Make sure you tell your doctor and pre-op nurses that your ride does not know what you’re having done. They will keep your confidence. But this isn’t recommended; find someone else to drive you if at all possible.)

If you’re living with your parents, it’ll be hard to hide the fact that you had surgery, but they don’t need to know what the surgery was for. Many other gynecologic laparoscopies and exploratory procedures have similar recovery periods. (A personal tip: saying you had a “minor gynecologic laparoscopy” is both truthful and keeps your private business private.)

6. After your surgery