Sperm Freezing for the Military: Your Country, Your Legacy
Serving your country is a great honor, and one that many individuals take great pride in. However, it does not come without its risks. Due to the often stressful and dangerous nature of the job, service members are frequently faced with greater risks to their health, including their reproductive potential.
This is why the US Military – specifically the Military Health System (MHS) – developed Tricare, an insurance provider that combines the resources of military hospitals & clinics with civilian healthcare networks. This program offers several healthcare plans, all ACA-compliant, and can provide comprehensive coverage that includes prescription drugs. According to a study of Veterans who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), 15.8% of women and 13.8% of men reported that they had experienced infertility. Nonetheless, Tricare coverage of infertility services has been relatively lacking, although efforts in recent years have been slowly changing this.
Tricare is set up to cover many health care needs with providers around the globe, keeping in mind that military members and their families often relocate or are stationed abroad. Additionally, many major civilian hospitals and clinics will offer discounted services for active duty military personnel and their families.
Who is eligible?
Generally, uniformed service members and their families are eligible to be covered under Tricare. A full list of eligibility requirements can be found at Tricare’s official website: https://www.tricare.mil/Plans/Eligibility
What IS covered:
Typically, the Tricare Basic Care program coverage is limited to services and supplies medically necessary for the diagnosis and/or treatment of injury, illness, or bodily malfunction. This would include cases of illness or injury involving the reproductive system and corrections of physical causes of infertility.
For the most part, this means that Tricare will cover medically necessary care that could lead to a natural conception. This would include diagnostic services such as semen analysis, hormone evaluation, chromosomal studies, and immunologic studies. Sometimes, preauthorization may be required.
What is NOT covered:
Non-coital reproductive procedures such as:
Artificial Insemination (such as Intra-uterine insemination)
Cryopreservation of embryos, eggs, and sperm
All other forms of Assistive Reproductive Technologies (ART)
These services are excluded from Tricare Basic Care as they are elective in nature and are not necessary to diagnose or treat a disease or illness.
However, there are certain exceptions to coverage or lack thereof. For one, if you were rendered infertile due to an injury or illness incurred during active duty, you may be eligible for expanded infertility treatment, such as IVF, cryopreservation, and implantation/insemination procedures.
Furthermore, veterans may also be eligible for extended coverage as of January 2017. Veterans that have “a service-connected disability that results in the inability of the veteran to procreate without the use of fertility treatment” will have expanded access to some procedures, including IVF.
Where are these services provided?
There are currently 6 military treatment facilities (MTFs) that provide the full range of fertility services. These are:
Walter Reed National Military Medical Center – Bethesda, Maryland
Tripler Army Medical Center – Honolulu, Hawaii
Naval Medical Center San Diego – San Diego, California
Womack Army Medical Center – Fayetteville, North Carolina
San Antonio Military Medical Center – San Antonio, Texas
Madigan Army Medical Center – Tacoma, Washington
These facilities are nationally recognized for excellent care and quality services. Additionally, although Tricare does not typically cover many ART procedures, the cost of many ARTs may be significantly reduced, including procedures such as IVF.
However, the use of these facilities may pose some disadvantages. The wait times can be very long, sometimes upwards of 18 months. They may also be quite distant from where you live.
What you need to know
Unfortunately, although the range of fertility procedures covered by Tricare has expanded in recent years, coverage remains relatively limited in this space. This means that active duty members may still be at considerable risk of damaging their reproductive potential with few potential backup options if they do.
In 2016, a bill named Women Veterans and Families Health Services bill, S. 319 passed in Congress, directing the Department of Defense to pay for the cryopreservation of sperm and eggs prior to deployment to a combat zone and up to a year after leaving the service. However, the bill went unfunded and the proposal was ultimately shelved in 2017. The future of coverage for such procedures remains uncertain.
This is why it is often recommended that active duty members take proactive steps to protect their fertility and preserve their gametes. Safe, affordable and convenient options such as Legacy have made it easier than ever to take the steps to protect your reproductive potential.