Tricare Prime and IUI/IVF

tlalli7106

It has been my understanding, reading online, that Tricare Prime does not cover any type of IVF, including IUI. Has anyone had any experience with IUI and possibly know an estimate of what out of pocket we will have to pay per procedure? Just looking down the road for DH and I and I think this is where we may be heading...

Gismo123

I think it depends where you are and the situation.  I've known a couple people where IVF was covered but in most cases no they aren't.  I've also known people where the IUI's and the meds were covered but then I've also known people where they only covered the meds.

I'm pretty sure the rules are different depending on where you're stationed.

Smudges*Mom

Here are some fairly recent threads discussing this topic (sorry they aren't clickable):

https://community.thebump.com/cs/ks/forums/thread/61569195.aspx

https://community.thebump.com/cs/ks/forums/thread/61054506.aspx

https://community.thebump.com/cs/ks/forums/thread/60814752.aspx

Hope this helps. Best of luck!

MyHusbandMyHero

I was a rare one who had our IVF covered. its VERY rare but it does happen.

we have an military REI clinic at our base hospital and IUIs are completely covered there and IVFs are $4,000 for those who have to pay out of pocket. I know there are several bases with REs (BAMC & Bethesda to name a few) but Im not sure which all hospitals have them, but its def worth looking into. At our base, BAMC, they bring in people from all over the state to use their IVF clinic since its the only one in the south DOD.

Good luck!!

The_Spanish_Inquisition

Tricare does not cover IVF or IUI. That said, I have heard the occasional random story about couples who did manage to have their cycles covered, but whether there were extenuating circumstances I don't know. There's a poster on this board who had IUI cycles covered by Tricare, I've forgotten her name.

Tricare is apparently not very clear about what they will cover re: infertility treatments. Generally, it's diagnostics and meds to help "fix" the issue, but not actual treatments. Another alternative is to go to one of the MTFs that provide IVF at a discounted cost. I think there are only 4 now - Bethesda (what used to be Walter Reed), Wilford Hall in TX, Tripler in Hawaii, and San Diego.

Anyway, OOP costs vary based on where you are and what services you need, but my experience is that IUI is 2-3k and IVF is 15-17k. '

GL!

jlgregory75

I'm in South TX and had an IUI. In the process right now of trying to get some of the procedures done at the specialist's office covered. I did pay for the IUI out of pocket which was $380. Other costs paid out of pocket were probably around $400-$500. If Tricare covers nothing in the end, my total costs for several visits and the IUI would be around $2000. I'm lucky that the IUI worked with the first round of Clomid.

sarahandeddiejune212008

Our IUI was only about $150 for the actual procedure.  I was really surprised at the low cost.

tochristy78

Basically what everyone else said. The diagnostic testing leading up to why there are infertility issues is covered (ie: visits to a RE, labs to determine issues, u/s, etc) but the actual treatment to deal with the infertility (ie: anything to actually get pregnant) is not covered by Tricare - but that is also the key. Treatments are not covered by Tricare but many base RE's will do procedures they do not charge you for which is how you get IUI's for as little as $150. We paid $700 for my IUI at a civilian clinic. But the wait at the MTF's can be significant. BAMC (Texas) has the longest wait for IVF, Walter Reed is the only other clinic and usually doesn't have a long wait as they can take more people per cycle. We traveled from Texas to WR (Wash DC) for our IVF cycle and thankfully am currently almost 11 weeks pregnant off our FET. IDK if you need IUI vs IVF but both BAMC and WR are good programs. The only other programs are San Diego and Hawaii but can only use if stationed there. Baby Dust!!

evjones22

hi! so we are stationed at camp lejeune (about 3 hours from bragg) and i was just searching the web to find stuff on IUI and one quesiton i was wondering was about freezing sperm.

My husbands abotu to deploy and with field stuff coming up, he wont be around for many months before he goes. I am surprised to hear how cheap that was!

did they do it at Womack too?!

can you give me more details?

That sounds so cheap? you paid 160 for the whole thing not incluiding freezing?

 Thanks!

dani1207

Tricare does not cover IVF, however, they do cover all diagnostic testing leading up to IVF. I have done two cycles at Walter Reed prior to them moving to Bethesda. Since we were stationed at Fort Monroe we were referred to WR for IVF. Basically you need to get your MTF RE to refer you. You should be able to get a referral to any of the military hospitals that do IVF. The cost ranges from $4500-$7000 at WR but is definitely cheaper than civilian. WR was excellent! We had a chemical preg the first round and were able to jump right into the next cycle which resulted in our b/g twins. Also, we didn't have to pay any extra for our mess except PIO which cost us a small co-pay of $3/box. If you have any questions feel free to message me.

ufsandra85

just went to the RE at portsmouth naval today and all meds are covered there (they werent at yale) and it costs 110 for iui. ivf they send you to walter reed which is where he wants me to head and it is about 8-10k which is a lot less than a civilian.

armwife

Hi I live at fort eustis. My dr just said we may have to do IUI. When you say portsmouth do you mean the one that in va? I ask cause i am not sure if there is one in SC. thanks

ufsandra85

yeah i live in hampton roads.