TRICARE Coverage for Fertility & Reproductive Health
Overview
TRICARE covers fertility testing and some fertility treatments. IVF coverage is limited to active duty members with service-connected conditions causing infertility. Basic fertility evaluations and treatments like IUI are more broadly covered.
Treatment Options Covered by TRICARE
- Fertility evaluation and testing
- Hormone testing and monitoring
- Ovulation induction medications
- Intrauterine insemination (IUI)
- In vitro fertilization (IVF) — service-connected only
- Surgical treatment of infertility
- Sperm banking (before deployment or treatment)
- Fertility preservation before cancer treatment
How TRICARE Covers Fertility & Reproductive Health
TRICARE covers medically necessary fertility evaluations and treatments. Basic fertility testing, ovulation induction, and IUI are covered for all eligible beneficiaries. IVF is covered only for active duty service members (and their spouses) with service-connected conditions causing infertility, such as injuries from combat or military service.
Coverage by Plan
TRICARE Prime
Fertility evaluation covered with referral. IUI covered. IVF only for service-connected infertility. Fertility medications covered per formulary.
TRICARE Select
Standard cost shares for fertility evaluation and IUI. IVF coverage same restrictions apply.
TRICARE For Life
Limited applicability for most TFL beneficiaries. Fertility testing covered if medically indicated.
Estimated Costs
| Scenario | Estimated Cost |
|---|---|
| Fertility evaluation (Prime ADFM) | $0 with referral |
| IUI procedure (Prime ADFM) | $0 with referral and authorization |
| IVF cycle (service-connected, Prime) | $0 with authorization |
| Fertility medications (military pharmacy) | $0 |
| IVF (not service-connected) | Not covered by TRICARE |
Authorization Requirements
IVF requires prior authorization and documentation of service-connected infertility. IUI may require authorization depending on regional contractor requirements. Fertility evaluations typically do not require prior authorization.
Network & Provider Notes
Reproductive endocrinologists are available in the TRICARE network. For IVF, authorized fertility centers must meet TRICARE requirements. MTF fertility services are available at some military medical centers.