Can someone tell me what fertility treatments Tricare covers? - Mothering Forums

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Old 01-16-2008, 07:14 PM - Thread Starter
 
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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!
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Old 01-16-2008, 11:42 PM
 
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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!
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Old 01-17-2008, 04:03 PM
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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.
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Old 01-19-2008, 05:19 PM
 
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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.
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Old 01-19-2008, 10:13 PM
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Would you mind sending me that link to the IVF in the military thread? It would be really helpful to me. Thanks!
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Old 10-29-2008, 06:48 PM
 
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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!
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Old 03-02-2009, 09:24 AM
 
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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!!
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Old 03-09-2010, 12:00 AM
 
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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.
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Old 03-09-2010, 02:50 AM
 
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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

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Old 03-10-2010, 12:03 AM
 
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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.

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Old 03-10-2010, 01:32 PM
 
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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!

*Aly* Proud ARMY Wife and SAHM to our IVF miracle London Michael 2/28/09 We are so in love! We beat infertility once, lets see if we can do it again. TTC #2!
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Old 03-10-2010, 01:59 PM
 
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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.

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Old 03-10-2010, 06:38 PM
 
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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!

*Aly* Proud ARMY Wife and SAHM to our IVF miracle London Michael 2/28/09 We are so in love! We beat infertility once, lets see if we can do it again. TTC #2!
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Old 03-10-2010, 06:42 PM
 
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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!

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Old 03-20-2010, 03:07 AM
 
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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

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Old 03-20-2010, 03:14 AM
 
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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.

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Old 04-21-2010, 12:43 AM
 
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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.

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Old 04-21-2010, 02:06 AM
 
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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!

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Old 04-21-2010, 08:53 PM
 
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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.

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Old 09-27-2010, 12:55 AM
 
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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!

TTC 2 years with my Airman
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Old 12-27-2010, 08:06 PM
 
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I know this thread is old but I'm hoping someone can help me out.I am a patient at MAMC on Fort Lewis and have been having a horrible time dealing with them. They never seem to have any availablility when I need appointments at specific times during my cycle. We are thinking of switching to Tricare Standard just so I dont' have to deal with this anymore. In the almost five months since my first appointment, I have only seen Dr. C once. If we go speak to patient advocacy is there any chance we will be approved to be seen off post? 

 


 

 

 

 

 

 

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Old 01-15-2011, 10:07 PM
 
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Hi there my husband is is the army. I had my tubes untied about 7 months. I found out it didn't work. Now my doctor told me that i have to go the fertility road. I have no clue were to start. I have an appt at ft carson with him. So i have no idea how to go about this. I'm not active duty. Can anyone help me? thank you

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Old 11-18-2011, 10:00 AM
 
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We live in Maryland and I just switched over from Tricare Prime to USFHP (US family health plan), a contracted insurance through Johns Hopkins.  I see a doctor in Lutherville, MD (where the infertility clinic is).  I am torn over my decision to switch from tricare prime to USFHP before embarking on this fertility adventure because of the associated costs.  I am looking for some info on what USFHP covers and does not cover when considering a round of IVF.  I have heard drugs are not covered and ultrasounds and labs are....  I was also told that soon the policy is going to start charging the same prices as Walter Reed and MTFs for IVF treatment but of course the insurance representatives know absolutely NOTHING and are incompetent when it comes to asking them about this.  I have gotten a price list from the Johns Hopkins finance office but the numbers are daunting and I don't even know which procedures will be used on me.  My HSG came back normal and everything else seems to be ok, I just don't get my periods very often, so thus I am probably not ovulating every month.  Have been trying for 16 months now, 4 months of clomid did nothing. Very frustrating.....and dealing with insurance companies makes it even less so.  It is not reassuring to wait for the bill to come in the mail and not know the exact $$$ amounts before starting treatment.  Anyone have any luck in freezing their embryos...that seemed to be a cheaper option...Thanks for any advice.  

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Old 01-26-2012, 04:14 PM
 
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I am in desperate need of answers and it seems no one can help.. Well, let me rephrase that... Everyone wants to help, they just all have different stories to go with my questions. Hopefully someone here can help. My husband and I are based out of Benning and we have Tricare Prime Remote. I was forced into getting my tubes tied in 2004(yes I said forced, Controlling ex husband that threatened to take my 2 boys if I didn't get it done) Now I am re married to My Perfect husband and we want child together, he has no children. I am open to getting my tubes un-tied and or IVF done. I have heard that Tricare will pay for partial then I heard it pays for all and of course i heard they wont pay anything.. Also that it depends on the type of tricare you have.. I am so confused as to where I should look or who I should talk to. I watched videos and asked people about IVF and they were very vague about it what it's about, one person told me it usually takes 2-3 times before getting pregnant.. My husband is only a SPC, we cant afford to do this 2-3 times. Granted we will but it would be nice to know what's covered for us and where to go to get the procedure done. Help please, any information on this would be outstanding. Thank you so much in advance 

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Old 01-26-2012, 04:19 PM
 
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CALL TRICARE!  Or go to their office, they have one in every Military Hospital.

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Old 01-26-2012, 04:23 PM
 
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Thank you for response, it is greatly appreciated.

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Old 02-09-2012, 05:06 AM
 
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hello,

I found your post very informative, you gave great information..one question right off the bat even though they do ivf at low cost would they allow a payment plan? or did you have to pay all up front? im medically retired from the army..so im not sure how this works..how long does the entire process take from begining labs to doing the ivf? i have pcos (polycystic ovarian syndrome) and a hole in one of my tubes..dont know how that happened ive never been pregnant..and have my period maybe once a year (due to the pcos) well anyhow id love any and all information on who to contact at the hospitals..i was stationed at bragg for 5 years..im now in texas..so san antonio would be close..but really ill travel wherever i need to for which hospital has the best success rates on pregnancy..this has been a life long dream for me..and im 30 years old and times running out..i need to do this very soon if im gonna have any chance at all..thanks so much..mary

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Old 02-09-2012, 05:29 AM
 
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hey im new at this site..but was wondering if you could read my post i think its comment num 26 or 27..im mary and wantred to know more about your post more info..like if we have to pay the mtf upfront of the ivf cost or will they let us pay monthly..and more about who to contact maybe some numbers and names..and how long from when you first started with labs to the final ivf process. plus if you knew what mtf had teh best success rate..thanks so much mary

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Old 02-09-2012, 04:59 PM
 
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The military moms and family have a social group here on Mothering.com it can be found here: Military Family Life

 

There is a thread just about Tricare and mothering, let's pool our collective information there. 

Currently and for many years there have been posts over MDC about tricare and so much info that is hard for each of us to find. 

This way we can learn from each other and gather it in one place so that the next lady looking for the same info can find us and what we found!

 

 

We would love to had you!


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Old 06-08-2012, 08:20 PM
 
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Hi Adorkable, I finally received a referral from my pcm to go to the Madigan MTF and am hoping that you can tell me what the process is there and what I should expect.

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