In Vitro Fertilization (IVF) is a medical procedure where an egg is fertilized by sperm outside the body, in a laboratory, and the resulting embryo is transferred to a uterus. IVF is a common form of Assisted Reproductive Technology (ART) used by families seeking to conceive. For military service members and their families, navigating reproductive health involves complex questions about coverage provided by the Department of Defense (DoD) and the Department of Veterans Affairs (VA).
TRICARE’s Standard Policy on IVF
TRICARE, the healthcare program for active-duty and retired service members and their families, generally excludes coverage for In Vitro Fertilization (IVF) and most other Assisted Reproductive Technology (ART) procedures. This exclusion applies when infertility is not directly connected to a service-related injury or illness. The standard policy considers these procedures to be outside the scope of covered medical benefits.
Despite this exclusion for IVF, TRICARE does cover a range of diagnostic services and treatments aimed at identifying and correcting the underlying causes of infertility. Coverage includes diagnostic testing, such as hormone level analysis and imaging, as well as basic fertility drugs used for ovulation induction. Surgical corrections for anatomical issues, such as structural blockages, are also covered under the standard benefit.
However, non-coital procedures, such as intrauterine insemination (IUI) and IVF itself, along with costs associated with donor gametes or embryo storage, are explicitly not covered under the standard plan. For the vast majority of service members experiencing infertility due to non-service-related causes, the financial burden of a full IVF cycle falls entirely on the family. These restrictions are rooted in long-standing federal statutes and DoD policy.
Specialized Coverage for Service-Related Injuries
A significant exception exists for active-duty service members (ADSMs) who sustained a serious or severe illness or injury while on active duty that resulted in the inability to procreate without the use of ART. This specialized benefit is provided under the Supplemental Health Care Program, often referred to as the DoD ART program. Eligibility requires a medical determination that the infertility is a direct consequence of a service-related condition, such as a neurological, physiological, or anatomical injury.
The DoD policy for this group has expanded to offer broader access, regardless of the service member’s marital status. Qualifying ADSMs can access services even if they are single or in an unmarried partnership, provided their partner is enrolled in TRICARE. The updated policy also allows for the use of donor gametes (egg or sperm), which was previously prohibited, offering a path to parenthood for those with complete gamete loss.
Treatment under this specialized program is typically provided at designated Military Treatment Facilities (MTFs) that participate in reproductive endocrinology programs, though private-sector care may be authorized. Covered services are comprehensive and include sperm and egg retrieval, Intracytoplasmic Sperm Injection (ICSI), IVF, and the cryopreservation and storage of embryos. The benefit is limited to a maximum of six egg retrieval attempts and three completed IVF cycles per service member.
Veteran Access to Fertility Treatment
Fertility treatment for veterans is managed separately through the Department of Veterans Affairs (VA), with specific benefits available under different criteria than those for active duty personnel. The VA offers fertility counseling and a range of non-IVF fertility treatments, such as hormonal therapies, surgical corrections, and intrauterine insemination (IUI), to all veterans enrolled in the VA medical benefits package. This coverage is available regardless of whether the infertility is service-connected.
However, access to In Vitro Fertilization through the VA is strictly limited to veterans whose inability to procreate is a direct result of a service-connected disability. This distinction is codified in federal law, specifically 38 U.S.C. 1787, which governs the provision of Assisted Reproductive Technology for this population. Eligible veterans can receive IVF, and the benefit also extends to a legal spouse, provided the veteran’s service-connected injury is the reason for the need for ART.
Recent policy changes at the VA have mirrored the DoD’s expansion, allowing eligible veterans to access IVF regardless of their marital status and permitting the use of donor gametes. The VA limits its IVF coverage to a lifetime total of six attempts to create embryos for three completed embryo transfer cycles. This benefit is contingent on Congress appropriating sufficient funds annually, which introduces a legislative dependency for the program’s continuation.
Patient Costs and Procedural Limitations
Even with specialized coverage, patients utilizing the DoD ART or VA IVF programs face certain out-of-pocket expenses and procedural limitations. The most significant cost that remains the patient’s responsibility is the acquisition of donor gametes, such as sperm, eggs, or embryos. While the programs allow their use, the high cost of purchasing these materials must be borne entirely by the service member or veteran.
Storage costs for gametes or embryos are generally covered while the service member remains on active duty or for the veteran’s lifetime, but other ancillary costs can accumulate. The specialized programs also impose strict procedural limits, such as a maximum age cutoff for the female partner, typically set at 49 years old. The number of covered cycles is capped, with both the DoD and VA programs limiting coverage to three completed IVF cycles per eligible individual.
For those service members who do not qualify for the service-connected exception, the full cost of an IVF cycle, which can range from approximately $5,000 to over $10,000 even at a military facility, must be paid out-of-pocket. This financial barrier, combined with the logistical complexity of scheduling treatments around military duty requirements, represents a substantial limitation for many military families seeking fertility care.