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Written by Anonymous

I met my partner, like many couples these days, a bit later in life — I was 36 and my partner 38. He was a reservist in the military, and when we were married a year and a half later, I got on his TRICARE insurance. Little did we know we would struggle to get pregnant for over two years, and the exorbitant cost of fertility treatments.

Since TRICARE is a federally funded program, they provide a few fertility treatments. Under TRICARE, a person might be eligible for one round of coital reproductive support (which basically means using fertility medications to improve chances at natural conception), and perhaps IVF if reproductive loss results from a service-connected injury which my partner did not qualify for. 

I started doing some research and found that our local military hospital provided reduced cost fertility treatments, but only if the member was on active duty, which my partner was not. Even if he was active duty, an IVF treatment cycle would range between $5,000 and $10,000. As of now, the current hospitals that are providing fertility treatments are: Brooke Army Medical Center at Fort Sam Houston in San Antonio, TX;  Naval Medical Center in San Diego, CA; Madigan Army Medical Center in Tacoma, WA; Tripler Army Medical Center in Honolulu, HI; ART Institute of Washington/Walter Reed National Military Medical Center in Bethesda, MD; and Womack Army Medical Center in Fort Bragg, NC (Military Families Magazine)

Out of frustration with my research, I spoke with a friend of mine who was also pursuing fertility treatment, and she recommended I research if my state had any laws mandating fertility coverage. I found out my state had fertility coverage benefits, and I used my state exchange open enrollment to apply for insurance. Luckily, I was eligible for open enrollment and used my state insurance plan to receive fertility coverage. 

While my journey has not been easy and has required a lot of research, here are some tips and tricks to reduce the cost of fertility treatments as a military spouse:

1. Check if your state covers fertility treatments- I used the website resolve.org to do my research. If your state provides fertility coverage, see if you can get insurance through the exchange during open enrollment or if you qualify for a special enrollment period. Do your due diligence when researching plans. I found reviews of different insurers and the ease of working with them for fertility treatments. Be sure to call each insurer and ask them what is covered, not covered, and if they require referrals from your primary care provider for services. This will help ensure that the services you may require are covered and what you can expect. 

2. If your state does not cover fertility treatments, see if your local military hospital provides fertility treatments at a discounted cost. When I researched my local military center, the cost of fertility treatment was significantly less than paying full price out-of-pocket. If you do not live near one of the military hospitals that support more affordable fertility treatments, see if whatever clinic you choose to work with provides a military discount because most do.

3. Even if you have insurance, track your spending. If your insurance covers fertility treatments, be sure to track how much you’re spending, because most insurances will have a lifetime maximum benefit and you want to make sure that you’re within that limit. For example, when I went to order my egg retrieval medication, the first pharmacy my clinic referred me to had higher costs for my medicine and I found a pharmacy that had lower cost medications billed to my insurance. While my lifetime benefit might seem high, with the exorbitant cost of fertility care, this can run out fast. 

4. If you have insurance, be sure to research if your fertility provider is in or out of network. You’ll find that some providers are out of network, and all the copays will add up. While I ultimately chose a provider who was out-of-network because I wanted to work with the provider who had the best statistical success in my area, for me it was well worth the copays, but I know not everyone can afford it.

5. Research best practices with fertility treatments. I found it helpful to research best practices in fertility treatments. An example that I can give you is that a fellow military spouse who did not do her research before working with a clinic, did her initial round of IVF without a hysteroscopy (a hysteroscopy is a procedure to ensure the uterus is clear for implantation). She sadly had two miscarriages after several rounds of IVF, and when she changed clinics, the clinic required a hysteroscopy as a best practice before implantation. She had multiple fibroids removed from the procedure, and afterward, she had three successful live births without the need for IVF. 

6. Reach out for support. I would have never known about these tips or tricks if I didn’t reach out for support. Networks like the Jewish Fertility Foundation were created to support individuals facing struggles with infertility, and I recommend taking advantage of these resources for both emotional and logistical support. 

And while I don’t feel comfortable writing my name publicly, because of the consequences for me and my family, if you reach out to Jewish Fertility Foundation, I’m happy to connect with you and support you further. You don’t have to do this alone. 

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