Armylove
05-22-2007, 01:54 AM
I am pretty new to all of this, and Im just curious as to how much fertility treatment tricare covers?
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View Full Version : Fertility treatments? Armylove 05-22-2007, 01:54 AM I am pretty new to all of this, and Im just curious as to how much fertility treatment tricare covers? Victoria 05-22-2007, 02:00 AM First off, doctors won't even begin testing until one has actively TTC'd for 1 year. They do cover meds such as Clomid. I don't think they cover IVF. kiwijus 05-22-2007, 02:32 AM Ok I was wrong about...all of it. Sorry. Dealing with Infertility What to Know before You Seek Treatment Nothing is more frustrating for couples than wanting to have a baby and being unable to conceive. Feelings of stress and helplessness are common in both men and women. Your TRICARE Prime benefit covers health care procedures related to diagnosing and correcting an underlying medical condition that is causing infertility. What’s Covered For men, hypothalamic disease, pituitary disease, disorders of sperm transport, disorders of sperm motility or function and/or sexual dysfunction may cause infertility. Under your TRICARE Prime benefit, infertility testing and treatment, including correction of the physical cause of infertility, is covered. Diagnostic services may include semen analysis, hormone evaluation, chromosomal studies, immunologic studies, special and sperm function tests and/or bacteriologic investigation. Therapy may include, but is not limited to, hormonal treatment, surgery, antibiotics, administration of HCG and/or radiation therapy, depending upon the cause. For women, services and supplies required to diagnose and treat illness or injury involving the female genital system are covered. Infertility testing and treatment, including correcting the physical cause of infertility, are included under this provision. This does not include artificial insemination, which is excluded from coverage. Artificial Reproduction Technologies Are Not Covered One of the primary things to know is that TRICARE cannot cover any form of artificial reproductive technologies, but can, in general, cover treatment of underlying medical condition. See the chart for some examples of covered and not covered procedures. Other Non-Covered Procedures Reversal of a prior surgical sterilization procedure is not covered. Services and supplies related to artificial insemination (including semen donors and semen banks), in-vitro fertilization, gamete intrafallopian transfer and all other noncoital reproductive technologies are also not covered. kiwijus 05-22-2007, 02:35 AM That came from here: https://www.triwest.com/triwest/default.html?/triwest/unauth/content/member_services/health_matters/archives/2005/issue4/infertility.html kiwijus 05-22-2007, 02:45 AM I THOUGHT a woman on another board I was on said that Tricare paid for her invetro, but I might be wrong. Your best bet is to ask your PCM, obviously. Ok, please forgive me if I'm being rash in posting this, if it's not an option for you and your DH, or you don't even want to consider it. I know you're asking about fertility, not adoption, but I thought you might be interested in this. It's from Military OneSource about adopting children. It outlines challenges, processes, what the military (tricare, etc) will and won't pay for. I haven't read it all yet but it's really interesting to me. Again, I'm sorry if I'm forward in assuming you'd like this info. I just know I would. http://www.militaryonesource.com/skins/MOS/display.aspx?IssueID=c6e56fa9-3e52-4d88-8904-f11fdba50ca1&ModuleID=ae74eaa3-d1b6-4dbd-b23e-354880172094&Action=material&ObjectID=40812347-c319-46a4-b657-da52c0211b20 Jennifer 05-22-2007, 02:51 AM Tricare WILL cover invitro, even if they say they don't. I know someone who had it paid for by Tricare, but it is a rare thing. I also know they do cover Tubal Reversals and Vasectomy Reversals. Your ebst bet is to talk to your PCM-but again, you have to have been actively TTC for 1 continuous year, and the first thing they will want you to do is chart, to see what your cycles are like and if you are ovulating, how long your LP is, etc. I've been looking into a lot of this recently, so PM me if you want to talk more. kiwijus 05-22-2007, 04:17 AM If you don't mind my asking, what are you looking for? I'd think you'd want sperm testing, and testing to make sure your cervical mucous isn't killing the sperm, and checking to see if you ovulate, etc. Are you willing to do in vetro? Adoption? I've never heard anything about it, but it doesn't seem to me that the military would endorse surrogate mothering, because of the legalities that can some out of that, plus since your DH is military technically someone else having his child (or both of yours, even) is (I think) still considered adultery. It's still something you'd want to ask about though, if that's what you're interested in. I don't mean to pry, it's just I'm in the same boat and my doctor is a b*tch (male, lol) about answering questions about this. He keeps telling me, "Well, you want to lose weight and get your thyroid under control before you try to get pregnant..." I don't even know HOW to chart. Jennifer 05-22-2007, 04:33 AM I don't mean to pry, it's just I'm in the same boat and my doctor is a b*tch (male, lol) about answering questions about this. He keeps telling me, "Well, you want to lose weight and get your thyroid under control before you try to get pregnant..." I don't even know HOW to chart. I don't really want to go into my situation on the board, but if you want to talk more PM me. Charting is really simple-you need a basal thermometer(10 bucks at walgreens) and it's easiest to join somewhere like www.fertilityfriend.com to record your temps. Taking Charge of Your Fertility by Toni Wexler(?) is a great book to read too. Kaymara 05-22-2007, 07:19 AM Before you can even consider fertility medication they will do testing. First is a semen anaylysis. 2nd is testing on you. This is all covered. They test males first because they are usually easier to "fix" Usually you need to be TTC for at least 1 full year (if under 30) and 6 months if over 30. After all that they can determine the course of action. Clomid is usually where they start. They will also cover injectibles. You have to fight to get them to cover some of the other stuff but it can be done. I never had to go past clomid.. Your best bet is to start at ground zero and go up. Once the military can no longer help they will refer ya into town and thats when you need to find out what is covered and what is not My situation is I have Polycystic ovarian Syndrome (PCOS) I did not ovulate on my own. Once I was FINALLY diagnosed and given the correct medication combo I fell pregnant with my son. But it took us 9.5 years of TTC etc to get to that point. But once I was on the right meds, my issues under control, I was pregnant right away. Like I said I was on fertiliy meds, I charted/temped, used a fertility monitor and a whole bunch of other stuff but it all worked and we got my son here that first month. So never give up hope. I am proof it CAN happen even if it has been awhile G'luck *tina* 05-22-2007, 12:34 PM Tricare does a cost-share for IVF at certain MTFs, Walter Reed, Bethesda, Balboa and Tripler. You pay half, they pay half basically. For when you are out in town, Tricare will cover meds, but not procedures for IVF. HEIDI 05-22-2007, 12:39 PM Tricare will also cover tubal reversals Armylove 05-22-2007, 12:43 PM k Armylove 05-22-2007, 12:45 PM unless I am completley wrong, and everything ive been told by my doctors is wrong. I dont have to wait 12 months if they already know that I am issues with my fertility. Thats why Im asking what they will cover. *~*Cori*~* 05-22-2007, 01:20 PM Good Luck Sweetie :hugs You know Im right there with you :goodvibes Kaymara 05-22-2007, 01:34 PM unless I am completley wrong, and everything ive been told by my doctors is wrong. I dont have to wait 12 months if they already know that I am issues with my fertility. Thats why Im asking what they will cover. If your Dr's are willing to do it sooner then so be it. But normally, to start, it is the 12 months. Every Dr is different tho.. G'luck Armylove 05-22-2007, 01:38 PM If your Dr's are willing to do it sooner then so be it. But normally, to start, it is the 12 months. Every Dr is different tho.. G'luck well, Im gonna have to wait at least 15 months because DH is deployed. But Im just curious as to what all the cover, since they know whats wrong with me, and they know its whats been causing the problems. And I have options of surgery to fix it, and they havent really gone over with me if tricare will cover the whole surgery or not, Kaymara 05-22-2007, 01:54 PM well, Im gonna have to wait at least 15 months because DH is deployed. But Im just curious as to what all the cover, since they know whats wrong with me, and they know its whats been causing the problems. And I have options of surgery to fix it, and they havent really gone over with me if tricare will cover the whole surgery or not, your best bet is to call tricare for your region and ask them to explain whats covered. Thats what I did. It changes all the time tho. Back in 2003 I was told male testing, female testing is covered. Male surgery is covered. Femal surgery such as lap etc is covered. IuI is covered. Injectibles were not covered and an IUI would not be covered if using injectibles. And IVF was not covered. But some MTF do cover some IVF. It really varies. So your best bet is to call. To kinda give ya an idea of how things change so fast. Tricare used to cover 2 ultrasounds when pregnant out in town. Then they changed it to 1. And just recently they changed it to none unless medically necc. I had to sign a form from my civ OBGYN stating I understood that any ultrasound would not be covered unless I had a problem to warrant it. All those changes occured in 2 years time... Angela P. 05-22-2007, 01:57 PM I am seeing a FS. Due to 2 m/c's and Tricare pays for every bit of it. They were going to pay for IVF..But the only thing they do not pay for is the storage of the little swimmers. Also you have to make sure you talk with your OBGYN and get a referral or Tricare will not pay for it. If you have any question pm me. |