Most insurance plans will not cover the reversal of a voluntary sterilization or any treatments designed to overcome infertility. There are fifteen states with insurance mandates requiring some form of coverage for infertility, but every one of these mandates specifically excludes covering reversal surgeries.
The best alternative is to take advantage of the tax deductible expenses, and to buy extra coverage for any resulting pregnancy: lower deductible health insurance, short term disability, hospital indemnity.
It is highly unlikely that your insurance carrier will cover the reversal of a tubal ligation. This is viewed as an elective procedure and elective procedures by definition aren't medically necessary. Perhaps it is an imperfect analogy but it would be viewed similarly to cosmetic surgery, perhaps desired by the policyholder but not required to maintain or improve the health of the policyholder. I have heard that there are relatively rare situations when a tubal ligation becomes the cause of health issues, in this scenario a doctor could make the case that medical necessity has become involved and then approval by the insurance carrier would become a much more distinct possibility. But, as I said, these are pretty rare events so I wouldn't place much hope in having a tubal ligation reversal covered by your health insurance.
The best alternative is to take advantage of the tax deductible expenses, and to buy extra coverage for any resulting pregnancy: lower deductible health insurance, short term disability, hospital indemnity.