Tricare won't cover progesterone? — The Bump
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Tricare won't cover progesterone?

I went in a little early for an u/s because I had been spotting (during the pelvic the NP freaked a little and said it was more like active light bleeding from my uterus) for 3 weeks straight. Now I'm on weekly u/s viability checks. They prescribed me progesterone suppositories. Buckley AFB pharmacy doesn't even keep them in stock and turned DH away. WalMart doesn't have them but can have them in by 3pm tomorrow. They just called to tell me that my insurance (prime remote) doesn't cover progesterone and it'll be $152 :-O

So the theory here is that TriCare finds miscarriages cheaper than birth? WTH?!? I'm fuming.

Re: Tricare won't cover progesterone?

  • I don't think Walmart pharmacies cover tricare scripts at all. Is there another pharmacy near you like a CVS? when I was on prime remote they covered my scrip costs. Call around quick and ask, praying for you!
  • Walmart does take Tricare. I switched to them after Walgreens dropped Tricare.
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  • 99% sure tricare covers progesterone. Call them directly. I didn't have the suppositories but the oral pills and they were covered 100% and I'm on the McKena (progesterone) shots now at $4,000 a vial (need 4 per pregnancy) without insurance and tricare has me covered 100% as long as it's through their approved pharmacy (it has to be shipped directly to my Dr, as most pharmacies don't carry it)
    image 05.06 @4w | 08.06 @5w | 03.07 @9w01.04.10 {RIP} AML | 09.11 @6w | 02.12 @7w10.22.12-11.04.12 {RIP} ASL | 09.13 @12wimage
  • I lucked out because WalMart couldn't got suppositories in stock, but they could get capsules... it was only $16! I'm hoping they stop the bleeding soon. Thanks @imfunsizeniki , I'll keep that in mind if this bean doesn't make it.
  • Tricare partially covers them. I had to be on them due to going through IVF. I ordered them from a mail in pharmacy. Without Tricare, they would have been over $500 for a 3 month supply, but with it I only paid $20.
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  • I'm on progesterone and I had my prescriptions filled either on base or at target, safeway, or walmart. Some employees are just unhappy with their lives or bad at their job, try asking to speak with someone else.
  • This includes the airmen on base. And I did have a co pay off $10 off base
  • The tricare website says it covered, you can look up by drug and see if it's covered and for what reasons. I'm overseas and while progesterone suppositories not carried at the pharmacy on post, I can get it on the economy and it is fully covered.
  • It's covered. If the pharmacy on base didn't have them in stock, you can coordinate with them and your OB to get them ordered to lower the out of pocket costs. I don't know if you have one, but Rite Aid has been my go-to for all our Rx needs since Walgreens stopped accepting Tricare.
    (We have Prime Ret.)
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  • I hope you got it covered. My husband and I conceived using iui and I was on progesterone suppositories as well as progesterone shots for the first trimester and I only paid $20 a prescription. Tricare covered part of all my fertility meds as well and progesterone was part of that before I was pregnant. If you ended up paying out of pocket I'd call them.
  • Hi Mrstaylarfrance. I also conceived via IUI. I'm on Tricare standard because I don't want to use the MTF as I work there. My progesterone and letrozole was covered (with co-pay) but none of my injectables were covered. Did you use injectables and if so which pharmacy did you use?  Congratulations on your baby!  I'm only 6 weeks and trying to hang on to this baby. 
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