Q. My spouse is enlisting. I've already been diagnosed with infertility problems. Once he joins and I get added to his medical coverage, what will Tricare cover and not cover in that general area?
A. Tricare covers what it calls "assisted reproductive services" only if such services are deemed medically necessary and are combined with natural conception. Prior authorization from a military hospital or clinic, or the beneficiary's Tricare regional contractor, is required. Services that may be covered include:
- Diagnosis and treatment for an illness or injury of the male or female reproductive system, including 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 and bacteriologic investigation.
Tricare does not 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 or stress.
- Noncoital reproductive procedures, services or supplies, including in vitro fertilization, gamete intrafallopian transfer, zygote intrafallopian transfer, or tubal embryo transfer.
More detail on what Tricare covers in a broad range of health areas is online.
Q. I've been married since 1992 to a former airman who retired in 2006 after 20 years of service. We're getting divorced. What will my Tricare benefits be after the divorce?
A. The so-called "20/20/20" rule granting continued indefinite Tricare coverage to former spouses has three requirements:
The service member must have served at least 20 years creditable toward military retirement; the marriage must have lasted at least 20 years; and the marriage and the member's service must have overlapped by at least 20 years. If you married in 1992 and your husband retired in 2006, the overlap between your marriage and his service was only 14 years, not 20.
Under a a corollary to the 20/20/20 rule called the 20/20/15 rule, the overlap between marriage and service is only 15 years, not 20. Under that rule, one year of extended Tricare coverage (rather than indefinite coverage) is granted to a former spouse after divorce.
But again, going by the dates you provide, you do not appear to meet the threshold for Tricare eligibility under the 20/20/15 rule, either.
Email tricarehelp@militarytimes.com. Include the word "Tricare" in the subject line.
