Fertility Care Coverage for TRICARE Beneficiaries

July 30, 2024

June 7, 2024

The Honorable Jack Reed
United States Senate
228 Russell Senate Office Building
Washington, DC 20510

The Honorable Roger Wicker
United States Senate
228 Russell Senate Office Building
Washington, DC 20510

The Honorable Mike Rogers
U.S. House of Representatives
2216 Rayburn House Office Building
Washington, DC 20515

The Honorable Adam Smith
U.S. House of Representatives
2216 Rayburn House Office Building
Washington, DC 20515

Re: Fertility Care Coverage for TRICARE Beneficiaries

Dear Chairman Reed, Ranking Member Wicker, Chairman Rogers, and Ranking Member Smith,

We write today on behalf of our constituents, many of whom make up the 10 million members of the uniformed servicemembers, retirees, caregivers and families covered by TRICARE, the health care system serving the American military community in the United States and around the world. As Congress engages in the legislative process for the Fiscal Year (FY) 2025 National Defense Authorization Act (NDAA), we strongly urge inclusion of expanded TRICARE benefits for comprehensive fertility care and family building options, including coverage for in vitro fertilization (IVF) and fertility cryopreservation.

As you may know, infertility is a disease that disproportionately affects service members and their families. The 2021 Blue Star Families Military Family Lifestyle Survey found that 42 percent of active-duty family respondents reported the military created challenges to having children. Female service members and veterans reported more challenges than their male peers. The same report found 67 percent of military-connected families experienced at least one family building challenge in their lifetime.

Military service is demanding. Service members and their families are subject to recurrent deployments and separations, frequent moves to new duty stations, and other military life stressors. They are also subject to a variety of occupational hazards – whether it involves a specific mission, impacts from blasts, or exposure to toxic materials that can be linked to infertility. These factors can make it difficult to build a family during and after active-duty service. To further complicate matters, fertility care is not a routinely covered health benefit under TRICARE. The threshold for TRICARE coverage is narrow, limited to active-duty service members incurring serious or severe illness or injury leading to an infertility diagnosis. This leaves many families in need to pay for expensive fertility treatments out of pocket. Discounted assisted reproductive technology (ART) services are offered at select military hospitals and local military treatment facilities (MTFs), though service members often face long wait lists for this care, which may be hours away from home.

In addition to our obligation to address service-related health issues and with growing tensions on the global stage, it is more important than ever to strengthen support for America’s warfighters and their families. Health care benefits are a significant employment consideration and crucial to inform military recruitment and retention efforts. Recent survey data indicated 77 percent of employees would be more inclined to stay with a company providing fertility benefits and as many as 88 percent would consider changing jobs to access fertility benefits. This overwhelming data suggests now is the time to extend fertility care benefits to service members and families covered by TRICARE. Further, a recent poll of 1,000 likely registered voters agree – 80 percent of respondents were in favor of IVF and fertility treatments for service members and their families.

In 2021, nearly half of employer-sponsored health plans covered in vitro fertilization (IVF), one of the most effective forms of ART. Most of these employers noted this expanded benefit had only a negligible impact on plan cost. There are currently 20 states that require at least some level of infertility coverage in their fully insured health plans. New in 2024, 14 Federal Employee Health Benefits (FEHB) Program carriers and 24 health plans cover IVF-related services, including medications, providing critical family building options for federal employees.

Servicemembers, families and caregivers have sacrificed much in service to our nation and should not have to sacrifice the opportunity to grow their families. Please do not allow another year to pass by without acknowledging and addressing the family-building challenges facing our military and veteran communities. As you work with your colleagues in a bipartisan and bicameral manner on the FY 2025 NDAA, we again urge the strengthening of TRICARE benefits to include coverage for infertility.

Thank you for your attention to this critical matter and for standing up for America’s military and retiree families.

Sincerely,

Steve Schwab
CEO
Elizabeth Dole Foundation

Chanin Nuntavong
Executive Director
American Legion

Julie Eshelman
Founder & CEO
Building Military Families Network

Ellen Gustafson and Katy Bell Hendrickson
Co-Directors
Military Family Building Coalition

Besa Pinchotti
CEO
National Military Family Association

Kara Dallman, USN (Ret)
Executive Director
Our Military Kids, Inc.

Heather Ehle-Ray
CEO/Founder
Project Sanctuary

Marjorie Morrison
Founder
Psych Hub

Tina Atherall
CEO
Psycharmor

David Gowel
CEO
RallyPoint

Heather Ansley
Chief Policy Officer
Paralyzed Veterans of America

Randy Reese
Executive Director
Disabled American Veterans

Brooks Tucker
Government Relations Contractor
Independence Fund

Shannon Razsadin
CEO
Military Family Advisory Network

Barbara Collura
President & CEO
Resolve

Amy Palmer
CEO/President
Soldiers’ Angels

Mrs. Ellyn Dunford
Spouse of the 19th Chairman of the Joint Chiefs of Staff, Joseph Francis Dunford Jr.

Bonnie Carroll
President/Founder
TAPS

Sally Ann Zoll, Ed.D
CEO (Interim)
United Through Reading

Women Veterans and Families Network (WVFN)

Megan Scherer
Co-Founder
Worth the Wait

Cc: Members of the House and Senate Armed Services Committee