Let's join together to get IVF coverage for TRICARE insurance Patients

aquafina · 09-10-2009, 02:54 PM

I'm in tears. Im frustrated with the lack of answers anyone has as to why TRICARE doesn't cover IVF costs. The reps on the phone even sound frustrated, commenting "they will cover anything that will get you sterile though"

I want to help change this policy. But I know its going to take more than just my voice.
I am going to write my congressman. The first step.

I was also told by the REP, we could try contacingt TMA, Tricare Mangament, they govern all of TRICARE.
Here is their address:
TMA
16401 Center Tech Parkway
Aurora, CO 80011-9043

Ironically, some other woman had called just 10 minutes before me, to the same women, with the same questions.
Please, even if you are able to get care at Walter Reed or some where else, wont you please take the time to help write. Make a difference. Even the cost at Walter Reed and other MTF's should be being covered.

Small retail businesses are offering full coverage for IVF, states Mandate it, but somehow TRICARE has found a way to feel they don't have to. It's not right.

Thanks for listening, and thank you even more, if you can take the time to write your congressman, or TMA.

Aloha!

brendalee0218 · 09-11-2009, 11:31 AM

I think you are doing a great thing. Unfortunately, we have been working diligently on this issue since August of 2007 with help from Special Operations Care Coalition. We went to the Pentagon last November and were one of 5 families on the panel. We even met the Secretary of Defense and told him about the issue. Ours was the issue of covering IVF for combat wounded to begin with. That is the reason we cannot have children naturally because my DH is now a spinal cord injury due to a helicopter crash in OEF. We were appauled that they wouldn't even cover that for service connected. I think it's a long road, but I think it's a road that will get paved. I'm most certain that once they start covering it for combat wounded, that it will open up doors for everyone else. Until then, I wish you luck!!
Brenda

aquafina · 09-11-2009, 11:55 AM

Wow, Brenda. Im so sorry for what happened to your husband, and am in disbelief, that there is not already something in place for couples in situations like you and your DH.

Did they give you a reason? Is your story/visit documented anywhere?

Why are they so hard nosed on this? I really dont understand.

For family in the EFMP programs they have just started a program this year, that pays the family childcare expenses, so they can "get out" up to 10 hours a week, no limit on kids. If a child is EFMP than they pay $10 a hour, and each sibling $6 an hour.
How can Tricare justify a special allowance for things like this, but not IVF??

brendalee0218 · 09-11-2009, 12:34 PM

Hi! Yeah no kidding hey! I do have a paper trail, that I would be willing to send you of things that have happened and direct contacts with TMA. The reason that it's NOT covered is because it's not considered "Physically or psychologically necessary" If you want more info, send me a PM with your email address and I'll send you what I have. We have even sent letters to the Washington Post, NY Times, and the Chicago Tribune with no luck. Let me know what I can help you with.
Brenda

JamieClr · 09-11-2009, 05:48 PM

Quote:

Originally Posted by brendalee0218

Hi! Yeah no kidding hey! I do have a paper trail, that I would be willing to send you of things that have happened and direct contacts with TMA. The reason that it's NOT covered is because it's not considered "Physically or psychologically necessary" If you want more info, send me a PM with your email address and I'll send you what I have. We have even sent letters to the Washington Post, NY Times, and the Chicago Tribune with no luck. Let me know what I can help you with.
Brenda

I wish something could be done! I'd love to ask why they cover things so couples can't get preg like visectomy etc, getting tubes tied ....but not ivf.

aquafina · 09-11-2009, 06:16 PM

I can't believe that is their excuse.

The whole biological/physiological reason we exsist is to reproduce.
And psychologically, the same, I cant believe that there isn't someone with a wife higher up with TRICARE, that could explain the major mental challenges not being able to get pregnant bring on to women (and men).

When states are mandating it for insurance companies how can TRICARE be getting around this?

Brenda I will send you a PM, Im going to DC to visit family in October, Im trying to get a meeting with our Senator from Hawaii, Abercrombie at that time.

Its very discouraging to hear that Tricare turned their back to you, and just makes me so mad.

JenX · 09-12-2009, 02:03 PM

But they do cover boob jobs....and I'm not talking the ones for breast cancer survivors.....those I understand completely.....

oh and viagra.....

cpgal · 09-13-2009, 07:51 AM

I find it horrible to think that someone with a service related injury cannot be covered for IVF - that is insane. And, should definitely be changed.

As for fertility treatments - certain states had enacted legislation, etc. To cover part of all of treatment. Military families are in better shape than most because a number of the drugs are covered and are not done so privately. And, the fact that certain MTFs provide treatment at such reduced cost is amazing.

But, until the can get the rates higher on actual birth I do not see it being covered. I work in health care insurance. No procedure with a 30% live birth rate is going to be covered by the military. If the rates were higher, they might. They do not cover boob jobs - they perform them to keep the surgeons in practice but the patient is paying for all costs minus the surgeon's time. Similar to IVF procedures at MTFs, the cost is less, but not free.

That being said - I would love for IVF to be be covered. But, if it doesn't work the first time - then you are talking multiple procedures with no guarantee. Some women have a baby the first go around - some it take 8 tries.

Writing Congress, getting a grass roots campaign behind it would be great.

Tiff238 · 09-15-2009, 06:06 AM

This is something that has astonished me for quite some time now. I just don't understand how IVF and IUI are not covered, especially when you have a medical condition that causes you to need it in the first place. I can't imagine anyone out there who would opt for IVF or IUI if they were able to conceive on their own naturally. I have heard of breast plants being covered, because they person has a low self esteem (I am not including breast cancer survivors, because that is entirely different!) I don't know about anyone else personally, but I know that my self esteem is extremely low, because I'm not able to conceive. And as for the woman who husband suffered a spinal cord injury...our country should be ashamed of itself for allowing him and his wife to be denied IVF!!! I can only image how much they have suffered and then to be told that we will not cover IVF. I'm sorry if it sounds like I'm up on a high horse, but this topic is near and dear to my heart. I am keeping all of you in my thoughts and prayers.

09-10-2009, 02:54 PM	#1 (permalink)
aquafina 0-99 post 2 of hearts Join Date: May 2006 Posts: 10	Let's join together to get IVF coverage for TRICARE insurance Patients I'm in tears. Im frustrated with the lack of answers anyone has as to why TRICARE doesn't cover IVF costs. The reps on the phone even sound frustrated, commenting "they will cover anything that will get you sterile though" I want to help change this policy. But I know its going to take more than just my voice. I am going to write my congressman. The first step. I was also told by the REP, we could try contacingt TMA, Tricare Mangament, they govern all of TRICARE. Here is their address: TMA 16401 Center Tech Parkway Aurora, CO 80011-9043 Ironically, some other woman had called just 10 minutes before me, to the same women, with the same questions. Please, even if you are able to get care at Walter Reed or some where else, wont you please take the time to help write. Make a difference. Even the cost at Walter Reed and other MTF's should be being covered. Small retail businesses are offering full coverage for IVF, states Mandate it, but somehow TRICARE has found a way to feel they don't have to. It's not right. Thanks for listening, and thank you even more, if you can take the time to write your congressman, or TMA. Aloha!

09-13-2009, 07:51 AM	#8 (permalink)
cpgal 400-499 post 6 of hearts Join Date: May 2009 Location: Washington, DC Posts: 426	I find it horrible to think that someone with a service related injury cannot be covered for IVF - that is insane. And, should definitely be changed. As for fertility treatments - certain states had enacted legislation, etc. To cover part of all of treatment. Military families are in better shape than most because a number of the drugs are covered and are not done so privately. And, the fact that certain MTFs provide treatment at such reduced cost is amazing. But, until the can get the rates higher on actual birth I do not see it being covered. I work in health care insurance. No procedure with a 30% live birth rate is going to be covered by the military. If the rates were higher, they might. They do not cover boob jobs - they perform them to keep the surgeons in practice but the patient is paying for all costs minus the surgeon's time. Similar to IVF procedures at MTFs, the cost is less, but not free. That being said - I would love for IVF to be be covered. But, if it doesn't work the first time - then you are talking multiple procedures with no guarantee. Some women have a baby the first go around - some it take 8 tries. Writing Congress, getting a grass roots campaign behind it would be great. __________________ Me 36, DH 37. 1st on our own missed miscarriage at 10 weeks (triploidy) Male factor infertility (morphology) IVF #1 1/2010 Beta #1 11dp 3dt 320 Beta #2 18dp 3dt 5796 1st U/S 6w - 2 sacs, 1 heartbeat 2nd U/S 6w6d -120 133 3rd U/S 8w3d -169 measuring 8w3d 174 measuring 8w6d TWINS!

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09-11-2009, 11:31 AM	#2 (permalink)
brendalee0218 100-199 post 3 of hearts Join Date: Jul 2008 Posts: 141	I think you are doing a great thing. Unfortunately, we have been working diligently on this issue since August of 2007 with help from Special Operations Care Coalition. We went to the Pentagon last November and were one of 5 families on the panel. We even met the Secretary of Defense and told him about the issue. Ours was the issue of covering IVF for combat wounded to begin with. That is the reason we cannot have children naturally because my DH is now a spinal cord injury due to a helicopter crash in OEF. We were appauled that they wouldn't even cover that for service connected. I think it's a long road, but I think it's a road that will get paved. I'm most certain that once they start covering it for combat wounded, that it will open up doors for everyone else. Until then, I wish you luck!! Brenda

09-11-2009, 11:55 AM	#3 (permalink)
aquafina 0-99 post 2 of hearts Join Date: May 2006 Posts: 10	Wow, Brenda. Im so sorry for what happened to your husband, and am in disbelief, that there is not already something in place for couples in situations like you and your DH. Did they give you a reason? Is your story/visit documented anywhere? Why are they so hard nosed on this? I really dont understand. For family in the EFMP programs they have just started a program this year, that pays the family childcare expenses, so they can "get out" up to 10 hours a week, no limit on kids. If a child is EFMP than they pay $10 a hour, and each sibling $6 an hour. How can Tricare justify a special allowance for things like this, but not IVF??

09-11-2009, 12:34 PM	#4 (permalink)
brendalee0218 100-199 post 3 of hearts Join Date: Jul 2008 Posts: 141	Hi! Yeah no kidding hey! I do have a paper trail, that I would be willing to send you of things that have happened and direct contacts with TMA. The reason that it's NOT covered is because it's not considered "Physically or psychologically necessary" If you want more info, send me a PM with your email address and I'll send you what I have. We have even sent letters to the Washington Post, NY Times, and the Chicago Tribune with no luck. Let me know what I can help you with. Brenda

09-11-2009, 06:16 PM	#6 (permalink)
aquafina 0-99 post 2 of hearts Join Date: May 2006 Posts: 10	I can't believe that is their excuse. The whole biological/physiological reason we exsist is to reproduce. And psychologically, the same, I cant believe that there isn't someone with a wife higher up with TRICARE, that could explain the major mental challenges not being able to get pregnant bring on to women (and men). When states are mandating it for insurance companies how can TRICARE be getting around this? Brenda I will send you a PM, Im going to DC to visit family in October, Im trying to get a meeting with our Senator from Hawaii, Abercrombie at that time. Its very discouraging to hear that Tricare turned their back to you, and just makes me so mad.

09-12-2009, 02:03 PM	#7 (permalink)
JenX 1000-4999 post queen of hearts Join Date: Nov 2006 Location: VA Posts: 3,073 Blog Entries: 12	But they do cover boob jobs....and I'm not talking the ones for breast cancer survivors.....those I understand completely..... oh and viagra.....

09-15-2009, 06:06 AM	#9 (permalink)
Tiff238 0-99 post 2 of hearts Join Date: Sep 2009 Location: Tampa, Fl Posts: 3	This is something that has astonished me for quite some time now. I just don't understand how IVF and IUI are not covered, especially when you have a medical condition that causes you to need it in the first place. I can't imagine anyone out there who would opt for IVF or IUI if they were able to conceive on their own naturally. I have heard of breast plants being covered, because they person has a low self esteem (I am not including breast cancer survivors, because that is entirely different!) I don't know about anyone else personally, but I know that my self esteem is extremely low, because I'm not able to conceive. And as for the woman who husband suffered a spinal cord injury...our country should be ashamed of itself for allowing him and his wife to be denied IVF!!! I can only image how much they have suffered and then to be told that we will not cover IVF. I'm sorry if it sounds like I'm up on a high horse, but this topic is near and dear to my heart. I am keeping all of you in my thoughts and prayers.