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TRICARE Offers Contraceptive Care to Support You, Your Family, and Your Readiness
Whether you're a service member or a TRICARE-eligible family member, contraceptive care plays a key role in your overall health, wellness, and quality of life. It also supports your individual and family readiness. TRICARE covers a full range of contraceptive methods, regardless of which health plan you have. And recent changes to TRICARE policies help make sure you'll have easy, convenient, and timely access to contraceptive services.
"Because contraceptive health care supports stability and flexibility, we looked at how to make contraceptive services both more affordable and accessible for all TRICARE beneficiaries," said Regina Julian, deputy assistant director for Health Care Operations, Defense Health Agency. "The waiving of cost-shares and copayments for certain contraceptive services is one way we're making it easier for you to get the care you need. Remember to ask your primary care provider if you have questions. You also can get medical advice 24 hours a day, seven days a week from registered nurses by calling the MHS Nurse Advice Line at 1-800-TRICARE, option 1."
It's important to note that contraception serves several purposes:
- Preventing pregnancy
- Supporting family planning
- Controlling menstrual cycles
- Treating menstrual-related conditions
Here are answers to common questions about TRICARE's coverage of contraceptive care and services.
Which types of contraceptive services no longer require cost-shares or copayments?
You no longer have to pay cost-shares or copayments for all TRICARE-covered reversible medical contraceptives. These include IUDs, hormonal shots, and slow-release hormonal rods, which go under the skin.
This change went into effect July 28. What do you do if you paid for services on or after July 28? You can submit a claim to your TRICARE contractor after Nov. 1 to receive reimbursement.
You should contact your TRICARE contractor if you have questions about cost-shares and copayments. You can also review costs details on the TRICARE Costs page.
Does TRICARE cover permanent birth control methods?
Starting Jan. 1, 2023, TRICARE will eliminate copayments and cost-shares for anyone who has TRICARE Prime and TRICARE Select and choose a permanent birth control method, such as tubal ligation. (Tubal ligation involves removing or sealing off the fallopian tubes.) It's the only form of permanent contraception that TRICARE covers, and a TRICARE-authorized network provider must perform the procedure. Cost-sharing may still apply for tubal ligations performed out-of-network. Cost-sharing for vasectomies and hysterectomies will still apply.
Does TRICARE cover emergency contraceptives?
Yes. TRICARE covers non-prescription emergency birth control to prevent pregnancy. (The morning-after pill is a common name for it.) You can get products such as Plan B One-Step at many retailers at no cost. This includes military pharmacies and retail network pharmacies. They don't require a prescription.
In addition, ella, is an emergency contraception also covered by TRICARE that requires a prescription. Ella can be more effective than Plan B when you take it within five days of unprotected sex. Ella is also available at no cost at military pharmacies and retail network pharmacies with a prescription.
What contraceptive services does TRICARE cover?
TRICARE covers a complete range of contraceptive services. TRICARE-covered birth control methods include:
- Birth control pill
- Birth control patch
- Diaphragm
- Vaginal ring
- Cervical cap
- Intrauterine devices (IUDs)
- Subdural progesterone implant
- Progesterone intermuscular shot
- Permanent contraception
Keep in mind, you must see a TRICARE-authorized provider for TRICARE to cover these services.
What contraceptive services doesn't TRICARE cover?
TRICARE doesn't cover:
- Condoms
- Nonprescription spermicidal foams, jellies, or sprays
- Reversal of permanent contraception, unlessmedically necessary
To learn more about what is or isn't covered, review the contraception chart on the TRICARE website.
Does TRICARE cover daily use prescription birth control pills and other drugs?
Yes. However, the Defense Health Agency can't currently waive cost-shares and copayments for daily use prescription birth control pills and other drugs. This is because TRICARE Pharmacy Program cost-sharing is mandated by law. You may have to pay a copayment for pharmacy contraceptives—like birth control pills and patches—depending on your health plan and where you fill your prescription.
TRICARE covers prescriptions filled at a pharmacy, consistent with other prescriptions from TRICARE:
- There's no cost to fill your prescriptions at a military pharmacy.
- If you use TRICARE Pharmacy Home Delivery, you may have a copayment depending on who you are, your plan, and your sponsor status.
- If you fill a prescription at a retail network pharmacy, you may have a copayment.
- If you fill prescriptions at a non-network pharmacy, you'll pay the full price.
"Contraceptive choices are highly personal," said Julian. "What's right for you may not be what's right for someone else, and your needs may change over time. The Defense Health Agency encourages you to participate fully in your own care."
Talk to your doctor or primary care manager about the types of birth control that's right for you. If you need to find a doctor, you can use the Find a Doctor tool. Your TRICARE contractor can also help you find a network provider.
Know your options for contraceptive care and how you can access that care, today and in the future. To learn more about services available to you, go to TRICARE's Birth Control Covered Services page.
Would you like the latest TRICARE news sent to you by email? Visit the TRICARE Subscriptions page today, and create your personalized profile to get benefit updates, news, and more.
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Source: https://www.health.mil/News/Articles/2022/09/30/TRICARE-Offers-Contraceptive-Care-to-Support-You
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