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Is It Covered?

Search the A-Z list for a list of covered services. Your coverage and out-of-pocket costs may vary based on who you are and your health plan option.

Assisted Reproductive Services

TRICARE may cover some types of assisted reproductive services.  The services must be medically necessary and combined with natural conception. 

Services that may be covered 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 only from physical causes
  • Diagnostic services including:
    • Semen analysis
    • Hormone evaluation
    • Chromosomal studies
    • Immunologic studies
    • Special and sperm function tests
    • Bacteriologic investigation

To get any assisted reproductive services, you must get prior authorization from:

  • Your military hospital or clinic, or
  • Your regional contractor

TRICARE doesn’t cover:

  • Artificial or intrauterine insemination
  • Any costs related to donors and semen banks
  • Reversal of tubal ligation or vasectomy
  • 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

Exceptions for Seriously Ill or Injured Service Members, Male or Female

If you are a service member who:

  • Is on active duty
  • Had a serious illness or injury on active duty
  • Lost natural reproductive ability due to that illness or injury
  • Have a lawful spouse

Then the following services may be available:

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

The following is not included:

  • Fertility preservation
  • Surrogacy

Contact your primary care manager or your Service point of contact for more information.

Disclaimer:

This A-Z list of topics is not all inclusive. TRICARE covers most inpatient and outpatient care that is medically necessary and considered proven. However, there are special rules or limits on certain types of care, while other types of care are not covered at all.

Last Updated 9/16/2014