Tricare, Infertiltiy — The Bump
Military Families

Tricare, Infertiltiy

Do any of you ladies have any help on getting a referral off post to a RE? I am on Tricare Prime and am getting my HSG next monday. After that I really want to talk to my Gynecologist about getting a referral to a RE because when he suggested Clomid he didn't say anything about monitoring. When I mentioned getting a referral he said I was still "young" and that they wouldn't approve a referral because I hadn't tried anything yet...? Also, how do I get a referral to BAMC? We are stationed at Fort Bliss, TX.
Married 2009. TTC 1yr. Forced break due to husband's deployment. TTC 2011-Present. Currently undergoing initial testing.

Re: Tricare, Infertiltiy

  • NSLNSL member

    My information is somewhat out of date since I was last seen at Walter Reed and later WBAMC for IF back in 2006, but Clomid sans monitoring seems to be standard at MTFs.  I was told at both hospitals that monitoring wasn't necessary, and I refused the prescription both times.  Transferring up to the hospital from your clinic won't likely result in a different treatment plan if my experience there is any indication.

    FWIW, I did receive a referral to a civilian RE clinic (the one on Mesa Hills on the West Side) after getting an HSG and undergoing a laproscopic surgery.  I wound up never using the referral because the lap uncovered and resolved my problem (scar tissue blocking my ovaries from my fallopian tubes, if you care) but I was not forced to try Clomid before the referral was granted.  My doctor did make it clear that treatments beyond the initial consultation wouldn't be covered by Tricare at all, and that medication coverage was really hit and miss based on who was processing the prescription orders.

    'You're young" is an incredibly frustrating thing to hear when you've been TTC for as long as you have, so I hope you're able to get a viable treatment plan in place soon.   

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  • If you do not get the support you want, need and know to be the appropriate next step, go see the patient advocate at your MTF.  "Being young" is not an acceptable reason to deny you access to an RE.

    Best of luck! 

    (And good for you for knowing you need to be monitored while taking Clomid.  I developed persistent cysts while taking it and the only reason we know that is because of monitoring.) 

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  • You have to have been trying to conceive for a year before you can get a referral for a specialist when it come to infertility. Sometimes they will send you to a base doctor just to check up on that. Next, there are very few REs that take tricare. Some bases have programs where you can be seen and treated on base but the waiting lists can be very long. At my last base I went to a civilian Ob/gyn and he put me on Clomid. At my current base I was seen by a RE because I got lucky and I live by the only one in the South that takes Tricare. If you want a referral just go to your PCM and ask for one. They can sometimes request a location and if they can't just call tricare and tell them you want to go to BAMC.
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