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Assisted Reproductive Services

Covered by TRICARE?Limits
It depends

Some services may be covered in certain situations

TRICARE may cover some types of assisted reproductive services.  The services must be medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and combined with natural conception. 

This includes:

  • Diagnosis and treatment for an illness or injury of the male or female reproductive system. This includes correcting any physical cause of infertility
  • Care for erectile dysfunction if it has a physical cause.
  • Diagnostic services like:
    • Semen analysis
    • Hormone evaluation
    • Chromosomal studies
    • Immunologic studies
    • Special and sperm function tests
    • Bacteriologic investigation

Check with your regional contractor before receiving services. They may require preauthorization.

TRICARE doesn’t cover:

  • Artificial or intrauterine insemination
  • Any costs related to donors or semen banks
  • Reversal of tubal ligation or vasectomy, unless medically necessary
  • Care for erectile dysfunction from psychological causes, including:
    • Depression
    • Anxiety
    • Stress
  • Non-coital reproductive procedures, services or supplies, including:
    • In vitro fertilization
    • Gamete intrafallopian transfer
    • Zygote intrafallopian transfer
    • Tubal embryo transfer

Were you injured on active duty?

If you're a service member (male or female) who:

  • Is on active duty,
  • Had a serious illness or injury while on active duty (Category II or III),
  • Lost natural reproductive ability due to that illness or injury, and
  • Has a lawful spouse

Then the following services may be available:

  • Sperm retrieval
  • Egg retrieval
  • In vitro fertilization (IVF)
  • Artificial insemination
  • Blastocyst implantation
  • Cryopreservation and storage of embryos

The following isn't included:

  • Fertility preservation
  • Surrogacy

If you get care or medication in the civilian sector, you must use participating network providers if available. You must get preauthorization for every IVF cycle.

Last Updated 9/28/2016