Military Health, Tricare programs - Military Times

Tricare Help: Why isn’t in vitro fertilization covered?

Q. If Tricare covers all other kinds of treatments for infertility, why does its regulations forbid it to pay for in vitro fertilization?

A. Years ago, before in vitro fertilization had been discovered, the same question was raised about artificial insemination. The answer then was that artificial insemination was not a treatment for infertility — it was technical assistance with conception. The same can be said about in vitro fertilization. Tricare covers the diagnosis and treatment of physical causes of infertility, but it does not cover services that address problems with conception.

Q. My wife and I got Tricare for Life earlier this year. What arrangements do we have to make with Tricare and Medicare so we are covered when we are out of town?

A. First, ask Tricare for a free Tricare for Life Handbook.

You are now Medicare beneficiaries because Medicare is your primary coverage. Tricare for Life consists of full coverage by Medicare Parts A and B plus full coverage by Tricare Standard. Both plans cover you nationwide.

You must get care only from Medicare providers. They know how to file Medicare claims. All you need for proof of insurance coverage are your Medicare and military ID cards.

After Medicare pays its share, it will forward the claim to Tricare, which usually pays the balance on the Medicare claim — your Medicare deductible and co-payment. All Tricare for Life payments are sent to the provider.

Some providers may ask for your Medicare co-payment upfront.

When Tricare pays its share to the provider, you will be due a refund from the provider of the amount Tricare paid.

If appropriate, call Medicare for information about your very limited emergency coverage in Canada and Mexico.

Tricare Standard provides coverage worldwide. Be sure to save all bills, receipts and other documents related to any foreign medical services you receive. Call Tricare for help filing claims after you return home.

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Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@atpco.com. In e-mail, include the word “Tricare” in the subject line.