Tricare Help: Is artificial insemination covered? - Getting out, military health issues - Navy Times

Tricare Help: Is artificial insemination covered?

James E. Hamby Jr. takes your questions on Tricare-related issues.

Q. My husband and I have been trying to get pregnant without success. Now, he is being deployed. Will Tricare cover artificial insemination with his sperm so we can continue to try every month while he is gone?

A. Although Tricare is allowed to cover medical treatment for infertility, it is not allowed by federal regulation to provide any kind of technical assistance with conception. Artificial fertilization, in vitro fertilization and similar procedures are not covered by Tricare.

Q. My mother and aunt died in a car wreck. My cousin has come to live with Dad and me. Dad is retired from the Army, so we have Tricare. Can we get it for my cousin? Like me, she is 19 and in college.

A. You are eligible for Tricare because of your father’s military service. That benefit, unfortunately, does not extend to family members other than the sponsor’s spouse and unmarried children younger than 21.

As long as you are a full-time college student, your Tricare eligibility can be extended until you marry, graduate or turn 23, whichever comes first.

If you live near a military hospital, it is remotely possible that your father can arrange for your cousin to get some of her medical care there at no cost. He would have to talk with the hospital’s patient administration office. If the personnel there say no, he could appeal to the hospital’s commanding officer.

Q. I will be 65 in March and will receive my Medicare ID card, which says I am eligible for Part A and Part B on March 1. The card does not say that I am eligible for Tricare for Life. How can I prove to doctors that I have Tricare for Life?

A. Tricare for Life consists of full coverage by Medicare Part A and Part B plus full coverage by Tricare Standard. You must be enrolled in both programs to have Tricare for Life.

Your Medicare ID card is proof of insurance for Medicare, which is the first half of Tricare for Life. Your current military retiree ID card, which proves your Tricare coverage, is the second half. You don’t need a separate card to prove your Tricare for Life eligibility.

Tricare for Life members must get all their medical care from Medicare providers. The provider will submit an ordinary Medicare claim, but in the space on the claim form that asks if the patient has secondary or supplemental insurance, the provider should put “Tricare” or “Tricare for Life.”

Medicare knows to forward that claim to Tricare when it finishes processing and pays the provider its share. Tricare will check with the Defense Enrollment Eligibility Reporting Service to ensure you are eligible for Tricare for Life and process the claim accordingly.