Does Military Insurance Cover IVF and What You Need to Know

The Tricare insurance program, which is the military's healthcare system, does cover some fertility treatments, including in vitro fertilization (IVF), but there are certain requirements and limitations to be aware of.

To be eligible for Tricare's IVF coverage, you typically need to have a diagnosis of infertility, which is defined as the inability to conceive after 12 months of unprotected sex. This requirement can be a challenge for some couples.

Tricare's IVF coverage also has a maximum number of attempts, typically 3-6 attempts, depending on the individual's circumstances.

Major insurance providers such as Aetna, Blue Cross Blue Shield, Cigna, United Healthcare, and Tricare offer fertility benefits, but your employer has to purchase them for you to be covered.

Some employers may choose not to offer any infertility benefit, but this is uncommon.

Diagnostic testing only is a more common type of benefit, covering procedures necessary to diagnose infertility causes, such as sonograms and semen analysis.

Diagnostic testing and limited treatment benefits also exist, covering diagnostic testing and treatment limited to ovulation induction and/or artificial insemination.

VA ART/IVF benefits are available to Veterans with a VBA-adjudicated service-connected disability or treatment of a VBA-adjudicated service-connected disability that is causally related to their infertility.

Eligible Veterans may be married, unmarried, or single, and the lawful spouse of an eligible Veteran is also eligible for benefits.

A Veteran's marital status is not a factor in determining their eligibility for VA ART/IVF benefits.

VA covers a wide range of fertility treatments, procedures, and services for eligible Veterans.

VA covers fertility evaluation and some treatments for all Veterans who use VA health care under the Medical Benefits Package.

For Veterans undergoing medical treatments that could cause infertility, VA covers fertility preservation, which involves freezing eggs or sperm to preserve them for an extended period of time.

This coverage is available if a necessary medical treatment is likely to prevent a Veteran from using their own eggs or sperm in the future, such as during cancer treatment like chemotherapy.

VA does not cover fertility preservation for delayed childbearing alone, however.

Storage of eggs or sperm for fertility preservation is covered for 10 years under the benefit.

IVF, or in vitro fertilization, is a type of assisted reproductive technology (ART) that involves handling human eggs and sperm outside the body to establish pregnancy. IVF is an ART procedure in which an egg is removed from a mature ovarian follicle and fertilized by a sperm cell outside the body.

The fertilized egg, also known as an embryo, is then allowed to develop in a protected environment for several days. It can either be transferred into a uterus or frozen (cryopreserved). According to the VA, IVF is now available to eligible unmarried Veterans and Veterans in same-sex marriages, as well as those using donated sperm or eggs.

IVF is a critical step for Veterans who are not able to produce their own sperm or eggs due to service-connected injuries and health conditions. The VA has expanded its IVF services to include the use of donor eggs, sperm, and embryos, which is a significant step forward for Veterans seeking to grow their families.

Here are some key ART/IVF procedures:

The VA has been working to expand its IVF services for years, including submitting legislative proposals to expand IVF services at VA. This expansion of care is part of the VA's continuing efforts to support Veterans who are seeking to grow their families.

Tricare, a military insurance provider, offers fertility benefits, including IVF treatment, but only if your employer purchases these features.

Major insurance providers like Aetna, Blue Cross Blue Shield, Cigna, and United Healthcare offer similar fertility benefits, but Tricare's specific coverage varies.

Your employer needs to purchase Tricare's fertility benefits for you to be covered.

Fertility insurance benefits exist at different levels, and Tricare's coverage can range from diagnostic testing only to all treatments covered.

Diagnostic testing only covers procedures necessary to diagnose infertility, such as sonograms, HSG, and semen analysis.

If Tricare covers all treatments, it may include IVF treatment and injectable medications, but often with a limit on the amount covered or the number of IVF attempts allowed.

This means patients with qualifying fertility insurance through Tricare may not have to pay out-of-network fees when undergoing IVF treatment.