Tricare infertility coverage can be a scary topic after getting an infertility diagnosis. Being a military family dealing with infertility can bring other troubles too (hello, service member always
Assisted Reproductive Technology (ART)
First, you will need to meet ART. This acronym is a fancy term that means helping couples reproduce medically. It can include anything from infertility testing to in vitro fertilization (IVF). Doctors have more than one way to help couples get pregnant, though, and have developed many ways to help them conceive. Tricare infertility coverage may or may not pay for some of these treatments, as it will depend on your specific situation. Tricare may also cover some medications if deemed “medically necessary”.
The key to figuring out whether your infertility treatments fall under Tricare infertility coverage is if it’s “medically necessary,” meaning your doctor says it’s appropriate and reasonable to get a specific treatment or medication. The service member must have a Category II or Category III injury or illness while on active duty. What the — what? Basically, Category II is an injury or illness in which doctors are unsure when the service member will return to duty. Category III is when a member will most likely be medically discharged because of that illness or injury. You can check out a list of tests Tricare will pay for here.
What’s Not Covered
Unfortunately, Tricare infertility coverage will not pay for some of the most effective treatments. If you need in vitro fertilization (IVF), intrauterine insemination (IUI), reversal of tubal ligations or vasectomies, embryo transfers (ET), surrogacy, or donor semen or eggs, you will have to pay for it. Tricare infertility coverage will not pay for the treatment of erectile dysfunction (ED) either, due to psychological causes. Most insurance companies in the U.S. do not cover fertility treatments at all. At least Tricare will cover some procedures. Tricare may or may not cover the cost of medications associated with those procedures. Again, it has to be deemed “medically necessary.”
Military Treatment Facilities
Hope is out there though. Because there are military treatment facilities that offer assisted reproductive technology (ART) at a much lower cost than at a non-military provider’s practice. If you are stationed at or near Bethesda, MD, San Diego, CA, San Antonio, TX, Tacoma, WA, or Honolulu, HI, the military treatment facilities (MTFs) there have ART clinics. Many couples have been blessed with having children through these clinics. Call the clinic nearest you as soon as possible because there may be a
The number one thing to remember about being a military couple going through infertility is you are not alone. It can be hard to talk about, but sharing your story with others helps erase the stigma of infertility.
Expecting a Baby While Your Spouse is Away?
Check out this article on What to Expect When You’re Expecting a Deployment Baby
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