The following information was published in November 2011 by RESOLVE The National Infertility Association. We know that wading through insurance policies and coverages can be daunting, and when added to a diagnosis of infertility…it only adds to the stress. What follows applies specifically to military personnel. First and foremost, we want to thank not only those currently serving, but those who have served our country in the past, as well as their families and friends.
Family building and fertility issues often fall to the bottom of the list of considerations for these families, and understandably so. There are options for military families needing treatment for infertility, and it’s important to understand these. First, know what is covered! You have the following options for receiving care such as an IUI or IVF procedure:
- Receive treatment at one of the Military Treatment Facilities (MTF) listed below. You will still need to pay out-of-pocket but the cost is less compared to the same services at a non-military clinic.
- Use your Tricare insurance coverage for medical care outside of a MTF, however, Tricare does not cover IVF or IUI’s, and may have limited coverage for other procedures. Check your plan first and talk to Tricare to get all the facts. And, if you are denied coverage, write a letter and appeal. Most insurance plans are not counting on you to appeal and you may get the coverage determination reversed.
- Pay out of pocket at a non-military clinic but ask the clinic about military discounts, drug discounts, and payment plans. Many clinics today are offering military discounts and can share with you information on discounts for your medications. Also, some clinics are contracted with Tricare to provide services via the Tricare insurance plan.
From the Tricare website: Infertility Treatment
TRICARE may cover the following types of infertility testing and treatment.
- Diagnostic services to identify physical illnesses or injuries to the reproductive system are covered for both men and women. Infertility treatments, corrective treatments and surgeries for women are also covered. However, correction of male infertility may be cost shared, which is determined on a case-by-case basis.
- Therapies covered by TRICARE include hormonal treatment, corrective surgery, antibiotics, administration of human chorionic gonadotropin (HCG) or radiation therapy depending on the cause. These therapies are covered for both sexes.
- TRICARE also provides medically necessary appropriate medical care for erectile dysfunction due to organic, vice psychological or psychiatric, causes.
- In-vitro fertilization (IVF) for women (see note below)
- Reversal of surgical sterilization is not covered for either sex.
A note about IVF: While TRICARE does not cover IVF, there are military treatment facilities (MTFs) where IVF medical training programs are conducted. Beneficiaries who participate in these programs will be responsible for all MTF costs.
Military Treatment Facilities offering IVF procedures:
- Wilford Hall, Lackland Air Force Base, in San Antonio, Texas
- Tripler Army Medical Center in Honolulu, HI
- Walter Reed National Military Medical Center, Bethesda, MD
- Naval Medical Center in San Diego, CA
- Madigan Army Medical Center, Tacoma, WA
- War is Hell (on Fertility)
Men’s Health, October 18, 2011
Family Act of 2011:
This pending legislation was introduced in 2011 in the U.S. Senate and will create a tax credit for the out-of-pocket costs associated with infertility medical treatment. Aptly named the Family Act of 2011, S 965 will potentially help thousands of people seek medical treatment that otherwise would be out of reach for them. Find out how you can get involved with supporting this bill and getting it passed by Congress.
A Bill to Establish a National Commission on Urotrauma:
The American Urological Association is advocating for H.R. 1612, a bill to direct the Secretary of Defense to establish a commission on urotrauma to study more effective treatments for those who suffer from these lifelong wounds. This legislation is similar to measures taken by prior Congresses to improve treatment of post-traumatic stress disorder and traumatic brain injury, which have also affected our troops with startling frequency in recent years. Urotrauma is a class of wounds to the genitourinary system, which includes the kidneys, and reproductive and urinary tract organs. These are some of the most common and debilitating injuries suffered by our servicemen and women from IED detonation and can cause infertility.
To find out more and take action, click here