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our military facility pcp referred me out to a fertility specialist. i opted to go with CHTRC paid out of pocket and was reimbursed only $251.00 i think only with the referral will tricare reimburse you. also each region is different. i do think that they reimburse more in tricare North than tricare south which was my case. Good luck with whatever you decide!
I am asking about Tri care prime, I had a tubal after the birth of my 3rd child from a previous marriage,@ 6yrs later i want a TR with so i can have a child with my new husband. He doesn't have any children of his own, we live close to DC i would like to get pregnant with in the next 2yrs, so getting on that waiting list doesn't really seem like an issue for us, i am wondering what is better though?? Letting the military perform the surgery or going ahead seeking a local doctor?? I know a few infertile couples who are referd to a local office, but i never went into detail on how much or if any, tri care will cover. Yes.. i know i will have to ask.
I was just curious on the approval process through insurance?? What happens when our family plan is different from PCP, wondering if military docs are different since i am a new wife?? I think i mostly worry the thoughts of other people considering this would be my 4th(last) pregnancy to put a happy ending to a newly blended family.
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You will have to call tricare because not only is each region a little different I know that the remote tricare is also a little different rules. Good luck
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I'm with Dani_elle - I live in San Antonio and my DH is AF and stationed at Lackland. I've been keeping in touch with the IVF coordinator over the last few months - they are booked solid. When I talked to her several months ago she said maybe they would have openings after the new year, so I checked back this week and she said now probably not till mid-year. They do perform the procedure, but the problem is getting in.
When I visited my PCM the nurse who screened me asked if my DH and I had any children together and we said no. She made sure to write that down in the chart. My PCM knew less than the nurse and tried to insist that they don't do the procedure. LOL! Wow! I told her they wouldn't list it on their website if they didn't perform the procedure. Duh!
Anywho! I talked to my DH yesterday and told him what the coordinator said. I told him we just need to start saving to go to CH and if we happen to get in here @ Lackland and they'll perform it, then we can use the $ we saved for the baby room. If not, then we can go ahead and get it done (hopefully this summer) @ CH. I'm 34 and will be 35 in June, so I'm not getting any younger and my DH will be 39 this month.
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A friend of mine Has Tricare thru her husband being in the Full time guard and it covered her Reversal. Tricare wanted her to go to the big Army hospital but she didn't..she used a local doctor and they still paid for it. I'll ask her how she got them too and I'll get back to you.
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i had my TR 12/19/08 so i am new. I called Tricare North on Monday and they will reimburse some. not much but some. You MUST have when to your PCM and asked for authorization/referral to CHTRC step 1. Then after TR when the nurse comes to the hotel she will hand you a receipt for insurance/tax purposes. Once your referral/authorization has been approved you will go to the Tricare website and feel out a beneficiary claim form and mail in your receipt along with the forms you filled out. The lady that I spoke to said depending on what codes are on your receipt and I have three that they could approve as much as 1800 but and here is the but most people only get back 200, and all of this is after the fact. So you will have to pay for everything out of pocket up front and if lucky get a few hundred back. I know its not much but its better then nothing. My husband and I talked about going to Walter Reed for quite some time because of it being cheaper. But we ultimately decided that we didn't want a military Dr working on me cause if they mess it up its kind of a one shot deal. so as the nurse mentioned you get what you pay for. To each person its their choice but I know for our family we made the best choice. If you are not sure about your region pick up the phone and ask what steps you need to do. Tricare is glad to answer your questions. Good Luck to everyone!
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Tricare South did cover the TR since my DH had no biological children of his own. Seems that that do it on a case by case basis. I had been referred to a RE but decided to go to CHTRC. Tricare just reimbursed me a whopping 251.11! Since it was out of network and minus the deductible, less the approved amount for the procedure. Well something is better than nothing!Hopefully this helps any of you ladies trying to decide which route to go.
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TriCare does not cover tubal reversal surgery unless you have surgery at a military hospital. In our experience, the military has a strict weight requirement (much more strict than our BMI requirement) and a very long waiting list - often years - before surgery is actually performed.
Almost ANY insurance company has an option for coverage for tubal reversal surgery, but you must elect that option when you purchase your insurance policy. It is a little like buying a car: two people can both by a Toyota, but one may choose CD player, sun roof, leather seats, while the other person chooses the standard package, which is less costly. Adding coverage for TR surgery will increase the premiums significantly! But there are companies and policies that pay all or part of the costs for the TR. The code - if you would like to check - is 58750.
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Hey, I have been a soldier for 12 years, and have asked this same question. The Air Force Hospital at Lackland Air Force Base in San Antonio does have a program that focuses more on IVF. The wait time just to get an initial consult is 8 months! Walter Reed Army Medical Center in Washington DC does have an extensive Probram that includes both TR and EVF. The wait time for the surgery is 4 months to a year depending on needs of wounded warriors. It costs 2000.00. It used to be a free service to soldiers and their family, but Tricare (Money Hungry HMO) put pressure on the hospital to charge money on account that they consider it to be an elective surgery. Anyway, the hospital does require ALOT of stuff paperwork wise before they consider you as a candidate for surgery.
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AngieB1 I worked for an insurance company for 15 years and I don't know of any circumstance under which a TR is covered because it is elective surgery. Insurance dollars are typically for medically necessary procedures and not the ones that we choose or want
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Tricare will pay for it if you go to a military facility that performs them. There is a long wait at times but they will do it at there locations. I know of at least 2. 1 in Tx and one in DC
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