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Can someone tell me what fertility treatments Tricare covers?

post #1 of 38
Thread Starter 
We have been TTC for 21 cycles now and have made now head way. DH and I are now going to seek professional help. We have Tricare Prime and I am wondering what fertiltiy treaatments Tricare covers? I've heard that they will only testing, pills, and injections, but will not cover IUI or IVF. Is this true? I know I could just call them and find out, but I just wanted to see if anyone has been throught this before. Thank you!
post #2 of 38
We have tricare prime remote. So far they have covered all of our appts, both for me and dh, they have covered all the tests including u/s, and all meds. It has not covered the actual procedure of IUI, or the sperm washing. I have not yet explored IVF, but I am under the assumption that all meds would be covered as well as u/s, but the actual retrieval and other procedures would not be covered. One of the problems I've had with tricare is that they require pre-auth. for all procedures, and sometimes there is not enough time to get an u/s approved in the short window in which it needs to be done. Also, some of the tricare programs cover the beneficiary but not the sponsor. I'm not sure how that relates to prime, but I think you can find that out from the tricare website.

HTH!
post #3 of 38
I am currently doing the same thing. Tricare pays for things to remedy a physical problem (they just paid for my laparoscopy). They do NOT pay for IUI, IVF, any ART, ultrasounds for any ART, injectable meds, and I'm sure a whole host of other things. They do pay for Clomid.

It is extremely difficult to get them to tell you what is or is not covered. I made a formal complaint and I was told that I have to have the provider call to find out, they won't tell me (which is a bunch of BS).

I don't understand why they don't have to cover infertility. They said in the complaint they cover only things that are "proven and tested" which should cover IVF and IUI. I asked why they aren't mandated to cover infertility because private insurance companies are mandated in my state and they said they aren't an insurance company but a government benefit.

I hate Tricare. I hope you find a solution. I have heard it is possible to get it done at Walter Reed and at the one at Ft Lewis (can't think of the name). I am not sure how you get into those programs though. Good luck.
post #4 of 38
I had a successful IVF cycle while I was Tricare Prime. Tricare did not pay for any of the meds or any part of the actual procedure. Some of the meds, like antibiotics or the birth control pills I had to take I was able to get at the base hospital. Once I was pregnant Tricare did pay for the ultrasounds, etc I had at my RE's office before being released to my OB. Although the idiot woman at the local Tricare office tried to tell me they didn't I knew they did.

She also tried to tell me that if Tricare found out my pregnancy was the result of IVF it would go after reimbursement for all money paid for my delivery.

Oh, and when I mentioned to her that they did IVF at Walter Reed her reply was "Well, they shouldn't be."

Oh my gosh, I can't imagine being so stupid and still being able to breathe.

I am not sure if I can post a link to another board titled IVF in the Military so PM me if you would like the link. Most of your questions can be answered there.
post #5 of 38
Would you mind sending me that link to the IVF in the military thread? It would be really helpful to me. Thanks!
post #6 of 38

tricare IVF

It is possible to get IVF through Tricare. There are several MTFs that offer IVF. These include Lackland AFB, Walter Reed Army Medical Center and Trippler Army medical center. If you type Walter Reed Army Medical Center IVF in google you should come up with there webpage that details the process.

I have found asking Tricare doesn't work but going directing though the MTFs does. It is not 100% free but only cost $4,400-$7,000. This is much cheaper then the civilian world. This is because all medication accept progresterone with oil are provided, the physicians are covered because they are military/government Doctors, and most diagnostic testing such as sonograms, laproscopic surgeries ect. are also covered. What you pay out of your pocket is for the IVF lab fees and embryologist. These are DOD awarded contracts and therefore are not covered.

Also travel is involved and can raise the cost. Since it is elective treatment a soldiers command can choose to give funded TDY or not. So stay on good grounds with your command and be open in communicateing them. Even though the command may fund travel for the active duty service member the spouse if not active duty will need to provide own travel such as airline tickets.

Either way it's still a good deal and Walter Reed has ranked in the top 10% of the nation with success rates for IVF. They also offer GIFT, ICSI and so forth.

Good luck to anyone pursueing this option!
post #7 of 38

Ivf

I know you can go to as someone previously said to Military Treatment Facilities for IVF and IUI. It does cost around 4500-6000. We went through process a couple of times, but never reached the point of actual implantation, due to deployments. We now live in Naples, Italy and there is a fertility clinic here ran by a British dr. that only costs 1070.00 euro for entire ivf process, we get our own meds. It is still a huge cut in cost even from the military's price. You might want to look into traveling over here. They are very proactive and helpful. They will not use donor sperm or donor eggs though, Italian policy. Good Luck!!
post #8 of 38
So, I also have done an IVF treatment at a private facility (not Military), and Tricare only covered the basics, leading up to the IVF. We are actually beginning the process again. I have been told since we are not stationed at one of the Bases that offers IVF, that we can not do the procedure at any of those facilities. I am going to pursue this, and the fact that Tricare does not assist it's Military members in expanding their families (yet you can go and have other "luxury" procedures done, that will be covered by Tricare, because they "boost morale"). I have been told that Infertility is not a major problem among the Military; which I don't believe is true. So at this point, I am kind of looking for a way to start some sort of action to change the way the Military and Tricare view everything that comes with infertility, or even adoption. Please let me know if you have any suggestions or ideas regarding this matter.

Thank you.
post #9 of 38
Joint Base Lewis McChord and it's MTF Madigan is also just now stating an IVF program. Theirs and the few others that happening around the Army is a test program to help the army and tricare decide how to go forward. We are at Madigan and might end up in the program if this goes too much longer.

outside those programs the drug cut off is drugs that are clearly intended for IUI or IVF are not cover. so clomid- yes, clomid plus injective boost- yes. full injectables- no
post #10 of 38
I got all my infertility treatment TTC DS covered when I was active duty. They also did semen analysis on XH. This time, I have VA healthcare, but since they don't do infertility, they transferred me onto the base for care (Wright-Patterson AFB). Since then, I've done four months of Femara with Ovidrel and two IUIs, plus one month of Follistim and Ovidrel with IUI. I haven't paid a cent (and Follistim is EXPENSIVE!). My doc said it would cost us $3-4,000 to do IVF, versus $12-13,000 for civilians. I would suggest calling up to your MTF directly and talking to the infertility or endocrinology expert to ask what they have available. I never had to go off base for care for anything.
post #11 of 38
I had my 12 month old after going through IVF at an Army MTF.

Yes, you can travel to do IVF at a different post. I know because that is what I did. You can also use MTF's for different branches (so if your Navy you can still do IVF at an Army MTF)

Tricare will cover EVERYTHING as long as it is not part of IUI or IVF.
So if you are working with a Dr to do a full cycle of injectibles and then just having sex to get pregnant. Tricare will cover ALL of those medicines/testing/ultrasounds/monitoring/etc... However the moment you move on to IUI or IVF they stop covering EVERYTHING. They will not pay for your ultrasounds,or monitoring, or anything anymore.

Ok so several MTF's do IVF and IUI's for a reduced rate. You are not actually paying the Dr. or the military. You are paying the civilian lab that they contract through. This is how it worked for us. The military Dr gave us our drugs FOR FREE. HE also did all of the monitoring and u/s. However when it came time for the retrieval, he did not have an embryology lab or embryologist on post. So he has a contract with an outside lab to use their facilities for a reduced rate. He does the actual retrieval and transfer himself, and we pay the lab to grow the embies. My IVF broke down to $6000-ish like this. $3500 for the Egg Retrieval, 1800 for ICSI (not everyone has to have this), and $750 for AH (again not everyone needs to have this either). So it's actually possible to do it all for around $3500 for some people.

The few MTF's that do IVF/IUI are:
Womack at Ft Bragg NC (which is where I did mine)
Madigan at Ft Lewis Washington
Walter Reed in Washington DC
Wilford Hall Air Force in San Antonio, TX
Balboa/Point Loma Naval, San Diego, CA
Tripler Army, Hawaii

If anyone wants more info just shoot me a PM and I will be happy to give you the cost list/wait list for those locations and also point you in the direction of alot more great information.

Good Luck!
post #12 of 38
Quote:
Originally Posted by Aly22681 View Post
Tricare will cover EVERYTHING as long as it is not part of IUI or IVF.
So if you are working with a Dr to do a full cycle of injectibles and then just having sex to get pregnant. Tricare will cover ALL of those medicines/testing/ultrasounds/monitoring/etc... However the moment you move on to IUI or IVF they stop covering EVERYTHING. They will not pay for your ultrasounds,or monitoring, or anything anymore.
This can't be true. I just got my third IUI a couple of weeks ago at Wright-Patterson AFB. The IUIs were done on the base by a military provider. I haven't had to pay for any of my medications, ultrasounds, or testing, and I'm not even covered under Tricare - I'm just a VA referral.

Also, I spoke to my doc about what we'd do if we did IVF. He said we'd do everything we could in the MTF, like ultrasounds or medications, and just do what they didn't have at the MTF at an outside facility. That and not having to pay the doc is why IVF would be so much cheaper than going to a civilian facility entirely.
post #13 of 38
Quote:
Originally Posted by minkajane View Post
This can't be true. I just got my third IUI a couple of weeks ago at Wright-Patterson AFB. The IUIs were done on the base by a military provider. I haven't had to pay for any of my medications, ultrasounds, or testing, and I'm not even covered under Tricare - I'm just a VA referral.

Also, I spoke to my doc about what we'd do if we did IVF. He said we'd do everything we could in the MTF, like ultrasounds or medications, and just do what they didn't have at the MTF at an outside facility. That and not having to pay the doc is why IVF would be so much cheaper than going to a civilian facility entirely.
Ok maybe I didn't explain that very clearly the first time, sorry.

If you are doing IVF/IUI at a MTF then yes, they cover everything (except sperm wash at some places for IUI) for your cycle. That is because those MTF's have special federal grants, that allow them the funds/time to have those programs. The only money you pay is when the MTF has to use a civilian lab for something (ex:sperm wash, embryologist, embryology lab, etc...)

If you are NOT in a location where there is a military IVF/IUI program then they will refer you to a civilian RE. That is when they will not pay for ANYTHING that is related to artificial insemination (like IUI or IVF). As long as you are trying to conceive naturally (sex) then they will cover everything.

Does that make better sense?

Oh and on a side note, Has Wright-Patterson AF started it's IVF program back up? Last I heard it was on an indefinite hold? That would be great for so many women in that area if they did. Good Luck!
post #14 of 38
Unfortunately, no. My doc would work with Kettering Reproductive Center if I wanted to do IVF. I would be over the moon if WPAFB did IVF!
post #15 of 38
i am being treated at Madigan and they have quite a few time very recently told me that they do not do IUI's, their grant program is for IVF only, they are working at getting it for IUI. currently we get our meds thru them and go to a local place for the sperm washing and iui
post #16 of 38
are you talking about Madigan RE clinic on the 3rd floor? i have been a patient there for 2 years and they have always told me that they send IUI's out, they sent me out in Dec for me first one.
post #17 of 38

Walter Reed IUI

I'm so glad I found this thread! We are lucky enough to live near Walter Reed. My husband is retired Navy and we have Tricare. I'm just starting this process (I've had an HSG test at Walter Reed and am on my first cycle of Clomid). We would consider attempting IUI if Clomid does not work. Does anyone know what the cost of IUI at Walter Reed might be? Is there a waiting list for IUI at WR? Thanks so much for any input.
post #18 of 38
just started another medicated cycle at Madigan, I'm going to ask again about the IUI and how some ladies have gotten it in house.
I just found out we are moving to Walter Reed in Aug, hopefully i will not still be TTC, but if I am at least Im at a pretty good place for it.

novanic, lets us know what you find at Walter Reed, if i need to get on any wait list, i will want to do it now before i get there, i have been in this for too long to sit around waiting to just get a chance!
post #19 of 38
Quote:
Originally Posted by cvpis4me View Post
WOW, really? I just had two IUI's last year, one in May and one in August. I know one of the doctors left for a while and as a result their IVF program turned into a 2-year wait which is why I traveled to Womack. But I didn't know they stopped doing IUI's. That's very odd.
just and FYI for folks, i was up at Madigan's RE clinic today and asked her about your IUI's there. They said that no way, no how do they do them any more and that you must have been one of the last since they stopped over a year ago to her recollection.
They are doing the IVF program at a reduced cost a handful of times a year. And continue to support IUI cycles with everything except the sperm collecting/washing and actual IUI.
post #20 of 38
Hi all! I'm brand new, and we are stationed at McChord AFB and I haven't been able to get a straight answer about IUI or IVF at Madigan.
If anyone has any information for me about doing IUI or IVF at a military facility would be very helpful. Thanks in advance!
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