Can you have your tubes tied at the same time as the RNY?

My sister would like to have WLS. Her insurance will cover it but she has to pay 20% of the bill. She was already planning to have her tubes tied and would be paying a few thousand to have that done. She is a stay at home mom and their budget doesn't have enough room in it to cover their portion of the charges for both having her tubes tied AND having WLS. Has anyone heard of them being done at the same time? Thanks for any input...

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