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Tricare and Infertility

dragontears507dragontears507 member
in Military Families
Hey all. I'm just about to wrap up my first cycle on Clomid...and it looks like an unsuccessful one. I tried to get a straight answer out of the doctor's billing department and Tricare but nobody seemed to want to tell me what will be and won't be covered.
I was told that they should cover the medications, meaning the Provera, Clomid, and even the HCG trigger shot, but probably not the ultrasound I had to have. I couldn't get a straight answer. My husband told me to go ahead and do it anyway, but I want to be prepared in case we get a whopping bill.
Anyone gone through IF treatment with Tricare?
BabyFruit Ticker
image

PCOS--TTC since 11/2010:   
5 cycles of Clomid: all BFN, 1 cycle of Follistim:CP
1 year break thanks to deployment.
1 cycle Follistim: BFN, Lap to remove peritubal cyst May 2013
2 cycles Follistim + trigger: BFN, Gonal F +IUI April 2014: BFP!!!!!! 

Boy/Girl Twins due Jan 5, 2015!!! 


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Re: Tricare and Infertility

  • lisa&andylisa&andy
    I saw an RE and all my medication, ultrasounds, and blood draws were all covered under my referral for infertility. Tricare won't cover IUI or IVF and anything that goes along with it (ultrasounds, etc.)
    Our Blog TTC since 10/2004 Follistim+Ovidril+Metformin=BFP on 12/8/08 2 heartbeats-12/30/08 Betas- 10DPO-104 12DPO-274 Photobucket Lilypie Third Birthday tickers
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  • lauren2_00@yahoo.comlauren2_00@yahoo.com member
    All my meds, ultrasounds, appointments, and blood draws have been covered through Tricare. I'm currently on my 5th IUI cycle and the only thing I've paid for OOP has been the sperm washing, which is done through the local IVF clinic. 
    TTC since 2007. Dx PCOS 6/2010
    4 unsuccessful rounds of Clomid
    Clomid 50mg - BFP #1 - February 7, 2010 Missed miscarriage March 25, 2010
    Clomid 100 mg - BFP #2 - October 28, 2010 Chemical pregnancy November 4, 2010
    IUI #1 - Gonal-F + Ovidrel = BFN
    IUI #2 - Femera + Gonal-F + Ovidrel + Endometrin = BFN
    IUI #3 - Gonal-F + Ovidrel + Endometrin = BFN
    IUI #4 - Gonal-F + Ovidrel + Endometrin = BFN
    IUI #5 - Menopur + Gonal-F + Ovidrel + Endometrin = BFN
    IVF #1 - Microdose Lupron Flare protocol = BFN
    FET = BFN - lost all remaining embryos
    IVF 2.0 - In progress. 20 retrieved. 16 mature. 10 fertilized with ICSI. 3, grade I embryos transferred, 7 made to freeze. Currently in the 2ww.
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  • MyHusbandMyHeroMyHusbandMyHero
    I did IVF through our military clinic. There are several posts farther back on this board that you should read with lots of info. I did IVF and that's not covered under tricare but IUIs are through them. All my meds, scans, and appts were covered but the actually procedure is not typically covered (ours was but it was under very special circumstances). If you're not close to one of the military REs and fertility clinics then your OB will be able to refer you and once you get the referral you'll be able to ask your REs office what is and is not covered by tricare.
    Married November 2007
    DH became a double above knee amputee with traumatic brain injury (TBI) - July 2009
    TTC - August 2009 DX: Severe MFI & TF due to TBI
    DH SA 0 count, started clomid therapy - November 2010
    DH SA 0 count, increased clomid dosage - January 2011
    DH SA 75 million with 60% motility!! - May 2011
    IVF with ICSI ONLY OPTION - May 2011
    3dt of 2 Grade A 8&7 cell embryos May 19, 2011
    +HPT May 30 2011 -- Memorial Day!
    Beta #1 = 34 Beta #2 = 101.8 Beta #3 = 603!
    Expecting beautiful Eden Grace February 7, 2012!
    I don't believe that God ever tells us "no". he has three options. Yes, not right now, or I have something better in mind. We just have to wait & see. BabyFetus Ticker
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  • jb2rnjb2rn member
    Are you seeing an RE? You didn't say. If not, please get a referral, don't waste time with an OB. Tricare covered my RE appts - bloodwork, and early pregnancy u/s. Also my HSG and the SA my husband had. I would have not qualified for IVF at a MTF due to my high FSH, so we would have had to be OOP for IVF.
    b/w=FSH 15.6, AMH 0.4 surprise natural BFP on 3/12/11
    DS born via unplanned C-section at 40w6d

    image

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  • ufsandra85ufsandra85 member
    same thing as everyone else. all of my appointments, us, bloodwork, and other tests have been covered. I have also had 2 surgeries and a SHG.

    Married 11/27/09 and TTC right away
    Dx: Complete septate uterus with cervical duplication, endometrial polyps, PCOS, endometriosis, hypo thyroid, luteal phase defect
    4 uterus surgeries to correct my complete septum and to remove polyps and 2 years of seeing the RE, medicated cycles and IUIs
    Baby 1 and 2: BFP 3/3/11 with 2 babies EDD 11/1/11, M/C 4/6/11
    Baby #3: 8/11 pregnant EDD 4/27/11 and m/c:(
    Baby #4: 10/12/11 BFP! EDD 6/16/12m/c 10/26/11
    Baby #5: 3/13/12 BFP! EDD 11/25/12 ANOTHER m/c :(

    Baby #6: 2/14/13- BFP! EDD 10/24/13, CP 2/19/13
    Baby #7: 3/15/13- BFP! EDD 11/27/13, another CP
    Baby #8.  BFP 5/19/13 EDD 1/22/14. 8 was not our lucky number

    4th septum resection on 5/31/13.
    Baby #9: 6/29/13 BFP. C section scheduled for March 5th!

    My miracle baby was born March 5 at 9:33am. He was 8 lbs 12.5 oz and 21.25 inches long!

    image"">

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  • dragontears507dragontears507 member
    Thanks everyone for the advice. I had a referral to an OB and he did an HSG and SA right away to make sure we didn't have any basic issues. Then, he started me on clomid. He seems to have it under control, but of course we had to move. Now, I'm trying to get a new referral to a doc out here, so I'll be sure to take all your advice and request a referral to an RE instead. Thanks!
    BabyFruit Ticker
    image

    PCOS--TTC since 11/2010:   
    5 cycles of Clomid: all BFN, 1 cycle of Follistim:CP
    1 year break thanks to deployment.
    1 cycle Follistim: BFN, Lap to remove peritubal cyst May 2013
    2 cycles Follistim + trigger: BFN, Gonal F +IUI April 2014: BFP!!!!!! 

    Boy/Girl Twins due Jan 5, 2015!!! 


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  • drcolleendrcolleen member
    Depends where you are, each MTF Commander decides so rules have been different different places I have been, e.g. at the post I work at now they do not pay for anything infertility related off post-- and note we do not have RE on post, but our pocket books are not deep enough to cover anything elective.  Ask locally if you don't want surprises.
    5/08- blighted ovum, spont ab; 2/20/09- epi, VAVD, Girl! breastfed 24mo; 10/10- blighted ovum, spon ab; 12/10- no fetal pole, Cytotec; 11/20/11- unmedicated SVD, Girl! breastfed 18mo; 11/7/13- unmedicated SVD, breastfed 18mo; 2/11/16- unmedicated SVD, exclusively pumping to at least a year.

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  • ufsandra85ufsandra85 member

    imagedrcolleen:
    Depends where you are, each MTF Commander decides so rules have been different different places I have been, e.g. at the post I work at now they do not pay for anything infertility related off post-- and note we do not have RE on post, but our pocket books are not deep enough to cover anything elective.  Ask locally if you don't want surprises.

     

    what if you have to have reproductive surgery? they still dont let you see an RE?

    Married 11/27/09 and TTC right away
    Dx: Complete septate uterus with cervical duplication, endometrial polyps, PCOS, endometriosis, hypo thyroid, luteal phase defect
    4 uterus surgeries to correct my complete septum and to remove polyps and 2 years of seeing the RE, medicated cycles and IUIs
    Baby 1 and 2: BFP 3/3/11 with 2 babies EDD 11/1/11, M/C 4/6/11
    Baby #3: 8/11 pregnant EDD 4/27/11 and m/c:(
    Baby #4: 10/12/11 BFP! EDD 6/16/12m/c 10/26/11
    Baby #5: 3/13/12 BFP! EDD 11/25/12 ANOTHER m/c :(

    Baby #6: 2/14/13- BFP! EDD 10/24/13, CP 2/19/13
    Baby #7: 3/15/13- BFP! EDD 11/27/13, another CP
    Baby #8.  BFP 5/19/13 EDD 1/22/14. 8 was not our lucky number

    4th septum resection on 5/31/13.
    Baby #9: 6/29/13 BFP. C section scheduled for March 5th!

    My miracle baby was born March 5 at 9:33am. He was 8 lbs 12.5 oz and 21.25 inches long!

    image"">

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  • jb2rnjb2rn member

    imagedrcolleen:
    Depends where you are, each MTF Commander decides so rules have been different different places I have been, e.g. at the post I work at now they do not pay for anything infertility related off post-- and note we do not have RE on post, but our pocket books are not deep enough to cover anything elective.  Ask locally if you don't want surprises.

    We didn't have an RE on post, either, but I had no problem getting a referral to one. There was no OOP cost to me for that.

    b/w=FSH 15.6, AMH 0.4 surprise natural BFP on 3/12/11
    DS born via unplanned C-section at 40w6d

    image

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  • hunt2005hunt2005 member

    imagedrcolleen:
    Depends where you are, each MTF Commander decides so rules have been different different places I have been, e.g. at the post I work at now they do not pay for anything infertility related off post-- and note we do not have RE on post, but our pocket books are not deep enough to cover anything elective.  Ask locally if you don't want surprises.

    It is NOT up to the MTF Commander. Call Tricare - it is up to them. They have patient care reps just for this purpose if the base MTF refuses to give you a referral.

    ~*~ Nikki ~*~ DS born 2/18/08! TTC #2 since 01/2009 11/01 Round #5 Clomid 100 mg, IUI 11/14, at 10dpiui 11/26 Beta:12dpiui 114 11/29 Beta:15dpiui 755 1/9/10 First U/S: TRIPLETS! 6/20/11 And then there were six... http://andbabiesmakesix.wordpress.com/ Lilypie Premature Baby tickers
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