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Tricare specifics on infertility coverage

Jul. 31, 2014 - 02:59PM   |  
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Q. My wife and I have been trying to have children for a while now and nothing seems to work. Does Tricare cover surrogacy or in vitro?

A. Tricare is picky about what it will and will not cover in this area.

For infertility, Tricare will cover:

■Diagnosis to identify physical illnesses or injuries to the reproductive system for both men and women. Infertility treatments, corrective treatments and surgeries for women are also covered.

■Therapies including hormonal treatment, corrective surgery, antibiotics, human chorionic gonadotropin or radiation therapy for both sexes.

■Medically necessary and appropriate medical care for erectile dysfunction due to organic — not psychological — causes.

Tricare does not cover services and supplies related to artificial insemination, in vitro fertilization or gamete intrafallopian transfer.

For surrogacy, the surrogate mother also must be a Tricare beneficiary and be willing to sign a contract with the adoptive parents. If those requirements are met, Tricare covers maternity care, including pregnancy, birth, postpartum care and any complications.

You and your wife should get an idea from a doctor of your best options, and then talk to the managed-care contractor for your Tricare region.

Q. I’m 18 and enlisting in the Army Reserve. I ship out to basic training in a few weeks. My girlfriend, also 18, is two months pregnant. Will Tricare cover the whole thing?

A. While you’re on active duty in basic training and Advanced Individual Training, the military will fully cover your health care needs. Once you move to drilling status in your Reserve unit, your military health care option will be Tricare Reserve Select, which requires enrollment and payment of monthly premiums.

Your girlfriend can’t be covered under Tricare unless you marry her. But once the baby is born, you can register him or her under your sponsorship in the Defense Enrollment Eligibility Reporting System. Then the baby can be covered under Tricare Reserve Select. More information on TRS is here: www.tricare.mil/TRS.

If you are called to active duty, you and any family members under your sponsorship become eligible for free military health care for as long as you’re on active duty and, depending on the type of mobilization, possibly for a period fter you demobilize.

Correction

A response in the July 21 Tricare Help column misstated Tricare policy on cost shares for Tricare Reserve Select beneficiaries who use military treatment facilities.

MTFs never collect cost shares from any beneficiary; they charge only a minimal daily subsistence fee for inpatients.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com. In email, include the word “Tricare” in the subject line and do not attach files. Get Tricare advice any time at www.militarytimes.com/tricarehelp.

Answers by RallyPoint

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