If your family is facing fertility challenges, the Coast Guard offers an array of policies and resources to support you. Even if you’re not focusing on family building yourself, you’ll want to be aware of the options available to your shipmates.
TRICARE Coverage
Although limited by statute from covering elective treatments, TRICARE does provide some assisted reproductive services. TRICARE can cover medically necessary diagnostic services needed for an infertility diagnosis. It can also cover the treatment for the illness or injury causing the infertility.
TRICARE may cover assisted reproductive services for service members who have sustained serious or severe illness or injury while on active duty, which led to the loss of their natural reproductive ability. This includes, but isn’t limited to, neurological, physiological, and anatomical injuries.
Reproductive Therapy
Six military treatment facilities offer reduced-cost reproductive therapies, including services not covered by TRICARE. These services are available for military members and their dependents. These facilities are:
- Walter Reed National Military Medical Center, Bethesda, Maryland
- Tripler Army Medical Center, Honolulu, Hawaii
- Womack Army Medical Center, Fayetteville, North Carolina
- Madigan Army Medical Center, Tacoma, Washington
- San Antonio Military Medical Center, San Antonio, Texas
- Naval Medical Center San Diego, San Diego, California
These facilities offer services to members regardless of the reasons for infertility, making them a good option for same-sex or other LGBTQIA+ couples who would otherwise not be covered under TRICARE.
While all six facilities offer similar assisted reproductive therapies (IUI, IVF, etc.), it is important to know that the process is not standard across all six facilities.
This means, for example, that if you start services at Tripler Army Medical Center in Hawaii and are transferred to San Francisco, starting the process again at Naval Medical Center San Diego can look quite different.
The waitlist length, price of services, and types of services offered at the MTFs vary by location, and will likely incur out-of-pocket expenses.
Members who do not live near one of these medical facilities may request permissive orders for leave and travel to doctor’s appointments. Travel costs, both in terms of time and money, are important for members to consider in their treatment plan.
Body Composition Screenings (aka Weigh-Ins)
Many fertility treatment options involve some form of hormone therapy, which can significantly impact a member’s weight. As the Coast Guard modernizes policies to better support female members, one recent change should make it easier for anybody going through fertility treatment.
The Weight and Body Fat Standards Program Manual now offers an abeyance for members going through assisted reproductive services and hormone replacement therapy.
If granted an abeyance, you’ll still participate in Body Composition Screenings, but won’t be penalized for any weight gain. The abeyance lasts 12 months, expiring only if you become pregnant. You can also apply for another 12-year abeyance if you need one.
To apply for a medical abeyance, work through your chain of command. You can find the full guidance on page 5-1 of the Coast Guard Weight and Body Fat Standards Program Manual, Chapter 5, Section A.
Support for Mental Health and Finances
Fertility issues can take an emotional, physical and financial toll. Several support resources are available to help both uniform members and civilian employees.
The Coast Guard’s personal financial managers are standing by to help you and your wallet navigate fertility treatment.
The service is continuing to expand its behavioral health program, with 13 counselors across the country.
CGSUPRT offers both mental health coaching and financial coaching. Virtual appointments are available if necessary, based on your geographic location and social distancing mandates. CGSUPRT also offers a ton of financial classes and webinars.
Chaplains are another resource for emotional support. All conversations with the chaplain are 100% confidential, meaning nothing said will leave that place. You do not have to be religious to go to your local chaplain for help. Chaplains can also connect you to additional services.
Lastly, please keep in mind that there are many different ways to form a family. Coast Guard members interested in adopting an infant or older child should look into Coast Guard Mutual Assistance adoption loans and the service's adoption reimbursement program.
Resources