FALLS CHURCH, Va. – Individuals who are facing challenges with infertility while trying to start a family may be wondering how TRICARE can provide assistance. Elan Green, chief of the Medical Benefits and Reimbursement Branch of the TRICARE Health Plan at the Defense Health Agency, emphasizes the importance of identifying the underlying causes of infertility through tests and services covered by TRICARE.
Infertility, defined by the Centers for Disease Control and Prevention as the inability to conceive after one year of unprotected sex, can affect anyone. Seeking a diagnosis and exploring treatment options are crucial steps for individuals or couples experiencing fertility issues.
Consulting with a primary care manager (PCM) or gynecologist is the first step in the process. These healthcare professionals will assess your medical history and may refer you to a reproductive endocrinologist for further evaluation through tests and exams.
TRICARE covers various diagnostic tests for infertility, including semen analysis, hormone evaluation, and bacteriologic investigations. Additionally, treatments to address physical causes of infertility are also covered, contingent upon medical necessity.
Individuals considering assisted reproductive technology (ART) services to overcome infertility may have options available at military hospitals and clinics. While TRICARE may not cover these services, they are accessible at reduced costs through specific military medical facilities that offer graduate medical education programs in reproductive endocrinology and infertility.
For service members who have suffered serious illnesses or injuries during active duty that impact their fertility, the Supplemental Health Care Program (SHCP) may provide coverage for ART services. These services, including sperm retrieval, in-vitro fertilization (IVF), and cryopreservation of embryos, are offered to qualifying individuals at no cost.
Recent updates to the DOD policy on ART for qualifying service members now extend coverage to TRICARE-enrolled unmarried partners and third-party gestational carriers, in addition to the qualifying service member and their spouse. This expansion of coverage aims to provide broader access to ART services for those in need.
Individuals seeking guidance on infertility diagnosis and treatment are encouraged to speak with their healthcare providers. It is essential to explore available resources and services under TRICARE to address fertility concerns and achieve family planning goals.