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Infertility Care for Military Personnel

Published November 2011. Updated August 2013.

If you are in the military or your spouse is, you need to know what your options are for treatment for your infertility.  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.

Exclusions:

  • 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:

Article:

Resources:

Are you a family building professional that provides discounts to active duty military and veteran families? Fill out this form and tell us about your discount program!

Take Action:

The Family Act:
In May 2011 a bill to create a tax credit for the out-of-pocket costs associated with infertility medical treatment was introduced in the U.S. Senate by Senator Kirsten Gillibrand (NY) and in the U.S. House of Representatives by Congressman John Lewis (GA). Aptly named the Family Act will potentially help thousands of people seek medical treatment that otherwise would be out of reach for them. RESOLVE supports this bill and needs your help getting this bill passed and made into a law. The bill died in the 112th Congress and must be re-introduced in the 113th Congress. 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 HR 984, a bill that requires the Department of Defense, in conjunction with the Departments of Veterans’ Affairs and Health & Human Services, to establish a national commission on urotrauma. The commission’s objectives are: 1) to conduct a comprehensive study of the present state of knowledge of the incidence and duration of, and morbidity and mortality rates resulting from urotrauma; 2) to study the social and economic impact of such conditions; 3) evaluate the public and private facilities and resources (including trained personnel and research activities) for the prevention, diagnosis, treatment of, and research in such conditions; and 4) to identify programs (including biological, behavioral, environmental, and social) through which improvement in the management of urotrauma can be accomplished. To find out more and take action, click here.

The Women Veterans and Other Health Care Improvements Act:
On January 24, 2013 U.S. Senator Patty Murray introduced the Women Veterans and Other Health Care Improvement Act S 131. A bill to amend title 38, United States Code, to improve the reproductive assistance provided by the Department of Veterans Affairs to severely wounded, ill, or injured veterans and their spouses, and for other purposes. This bill will provide access to fertility treatment for seriously injured veterans and their spouses, adoption assistance, permanent authority for VA to provide child care, and other elements. On March 5, 2013, U.S. Representative Larsen introduced this bill in the House of Representatives. Find out more about this pending legislation.

Read personal stories from RESOLVE constituents who are military families.