YOUR TRICARE FERTILITY COVERAGE EXPLAINED

TRICARE fertility coverage is complex. Until 2024, regulations restricted how TRICARE benefits were set up when it came to reproductive health, and there are still plenty of guidelines to follow. However, there are now some exceptions and more wiggle room for service members involving assisted reproductive technology (ART), including in vitro fertilization (IVF). To better understand your coverage, speaking with your TRICARE representative and healthcare team is going to be your best option; however, we’re looking at how the new Defense Department (DoD) policy affects coverage for those serving.

Does TRICARE Cover IVF?

Generally, TRICARE fertility coverage doesn’t cover IVF or any other ART services, such as egg freezing (cryopreservation), intrauterine insemination (IUI), etc.

However, due to new guidelines from the DoD in 2024, there are some exceptions available to military families increasing the resources available.

TRICARE Fertility Coverage 2024 Through Supplemental Benefits

A new ART policy from the DoD is allowing certain military members to have access to these healthcare services beginning in 2024.

To be eligible, you’ll need to be married and you can’t have eggs or sperm donated by a third party.

This portion of the guidelines has met criticism as it makes it virtually impossible for same-sex couples to access these benefits as a result.

It’s worth noting that donated gametes or embryos are allowed; however, the DoD won’t cover the costs and any surrogates in TRICARE can’t be paid for their role. The one exception is receiving a waiver, in some cases, for travel.

Furthermore, infertility must be caused by a service-connected injury or illness in order to have access to these benefits, rated as Category II or Category III.

Officially, ART benefits aren’t part of the core TRICARE fertility coverage available but are instead found under the Supplemental Health Care Program.

IVF Military Services Available

• Blastocyst implantation

• Cryopreservation and storage of embryos

• Egg and sperm retrieval

• IUI

• IVF

While these services are available, you still need authorization beforehand, with the exception of cryopreservation/egg freezing.

Furthermore, the cost of gamete cryopreservation and/or storage is shared with the DoD, but only while you’re in the military. You’ll need to cover these costs after you separate from the service.

Finally, there are limits for each treatment in place by the DoD and active duty members are unlikely to be eligible.

IVF Military Facilities

If you’re in need of IVF or ART services, there are private sector facilities available; however, it’s preferred by the DoD to have them conducted at a military hospital when you are able to.

These eight military hospitals provide proper healthcare options as they all offer obstetrics and gynecology reproductive endocrinology and infertility graduate medical education programs:

• Brooke Army Medical Center (BAMC) in Fort Sam Houston, TX

• Madigan Army Medical Center (MAMC) in Joint Base Lewis-McChord, WA

• Naval Medical Center Portsmouth (NMCP) in Portsmouth, VA

• Naval Medical Center San Diego (NMCSD) in San Diego, CA

• Tripler Army Medical Center (TAMC) in Honolulu, HI

• Walter Reed National Military Medical Center (WRNMMC) in Bethesda, MD

• Womack Army Medical Center (WAMC) in Fort Liberty, NC

• Wright Patterson Medical Center/88th Medical Group (WPAFB) in Greene County, OH

Keep in mind that while these reproductive health services are less expensive at military hospitals, they are only provided on a first-come, first-serve basis.

Does TRICARE Cover Fertility Testing?

If it’s medically necessary, TRICARE fertility coverage is available for testing; however, this varies on an individual basis. You’ll need to confirm your fertility testing options with your TRICARE contractor, as you may need authorization beforehand.

Sources:

Assisted Reproductive Technology (ART) Services, TRICARE. Accessed September 2024. https://www.tricare.mil/CoveredServices/IsItCovered/AssistedReproductiveServices

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