In 2024, Tricare broadened its fertility treatment coverage, extending eligibility to unmarried service members and those requiring donor eggs or sperm, marking a significant policy shift by the Defense Department. This update, effective March 8, 2024, diverges from previous limitations that restricted assisted reproductive technology (ART) to married service members and excluded third-party donations, which had notably excluded same-sex couples from accessing these benefits.
Eligibility Criteria: Military fertility benefits differ from civilian sector perks, as they are specifically designed for service members whose infertility is directly linked to a service-related injury or illness. Under the new policy, the Department of Defense (DoD) does not require proof of unsuccessful conception attempts. Instead, eligibility is determined by a service-connected condition that impairs procreative abilities, which could include neurological, physiological, or anatomical injuries. To qualify, these conditions must be classified as either "Category II" or "Category III," often indicating a likelihood of medical discharge.
Coverage Details: The fertility services covered by Tricare are part of a Supplemental Health Care Program and include sperm and egg retrieval, in-vitro fertilization (IVF), intrauterine insemination (IUI), blastocyst implantation, and the cryopreservation and storage of embryos. Prior authorization is required for each significant procedure, such as IUI, gamete retrieval, embryo transfer, and IVF cycles. While donated gametes or embryos are permitted, their acquisition is at the service member's expense, though the DoD does share in the costs of gamete cryopreservation and storage until the service member exits military service.
Service members can also include a spouse, a Tricare-enrolled unmarried partner, or a "third-party gestational carrier" (surrogate), though surrogates cannot be compensated beyond potential travel waivers. The DoD also sets limits on the number of treatment attempts, such as up to six egg retrievals and three full IVF cycles.
Treatment Locations: The preferred locations for receiving these treatments are military hospitals, although services through Tricare network providers in the private sector are also an option. Key military facilities offering these services include Walter Reed National Military Medical Center in Maryland, Tripler Army Medical Center in Honolulu, and several others across the country.
Management of Benefits: Timing is crucial in fertility treatments. While not mandatory, some service members might receive assistance in managing their fertility benefits effectively, with companies like WIN overseeing benefit management for specific projects within the Navy, Air Force, Space Force, and Coast Guard.
This expansion of fertility benefits reflects the DoD’s evolving approach to healthcare, ensuring more inclusive and comprehensive support for service members facing fertility challenges.
Download, the updated DOD Policy by Clicking Below.
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John Reuter
The Veteran Realtor