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TriCare insurance question


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#1 AmazinGrace

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Posted 11 January 2012 - 03:44 PM

I am new to all this and have a few questions.
Quick background, I am the IP, after 9 IUIs (one chem pg and the rest BFN) and 6 IVFs all ending in m/c, DH and I have decided to try IVF one more time and if I am unable to carry to term then start with surrogacy late summer/early fall.
One of my best friends, almost like my sister, offered to be my surrogate and so I am trying to inquire about coverage before moving further.
We are both military wives and both covered under Tricare. I know Tricare has changed their coverage around for surrogacy but I am not sure what is covered and what is not, especially since we both are covered with the Tricare.
Can anyone be of some assistance with me, or give me a little insight?

#2 ready4this

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Posted 11 January 2012 - 04:03 PM

:welcomeani:

I'm sorry I don't have any type of answer to your question :/ I dont know anything about insurance, but I look forward to hearing how things go :)

#3 juju

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Posted 11 January 2012 - 05:09 PM

She will have to look at her benefits and just make sure there is not a surrogacy exclusion. Just make sure she reads carefully because sometimes they do mention an exclusion for IP's - just saying that the IP's insurance will not cover a surrogate.

#4 Amaraine

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Posted 11 January 2012 - 05:10 PM

Welcome! I'm so very sorry for your losses, but am so glad that surrogacy is the right path for you. :)

The best thing for you to do would be to contact a Tricare representative. It is my understanding that if both the IP and SM are covered under Tricare, then they will cover the pregnancy - but I am no authority. Good luck!!

#5 Mavis

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Posted 11 January 2012 - 05:21 PM

I am with Tricare as well and the change came right before we signed contracts. I don't know all the technical lingo, but my lawyer had me get separate insurance that my IF pays for. I guess with Tricare they will now bill the IP's up to a certain reasonable amount for a routine pregnancy. But if it isn't routine they have the right to bill more. I know there is more too it, but the problem with it is that it leaves too much room for Tricare to bill the IP's (you in this case) what they see as reasonable. So you may not be able to plan ahead with that.

#6 GSinIN

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Posted 11 January 2012 - 07:21 PM

I have Tricare. They told me that they would pay after the IP's paid a 'reasonable amount'. The 'reasonable amount' was quoted as $15,000-$50,000 depending on actual costs. They would not confirm a specific amount until after I delivered. We chose to go self pay. Yes, their policy used to state that if both the IPs and GS were covered then they would cover the costs. That verbiage has been removed from the handbook. I would call and ask. More specifically, I would call and ask the program integrity/fraud department.

#7 traci72

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Posted 11 January 2012 - 09:18 PM

Tricare can and WILL come after her comp. There are many, many surro's who have been "screwed" by Tricare over "reasonable coverage" and had even had specific amts written into their contracts for what the IP's would pay...Tricare rescinded all payments. They have gone on national T.V. making it clear that they do monitor some sites and that they will flag and go after surrogate's to get any monies paid by Tricare reimbursed. Even getting things in writing from Tricare hasn't protected surrogate's. I would be very leary of trying to use them as primary insurance for a surro-pg.

#8 juju

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Posted 12 January 2012 - 09:40 AM

Tricare can and WILL come after her comp. There are many, many surro's who have been "screwed" by Tricare over "reasonable coverage" and had even had specific amts written into their contracts for what the IP's would pay...Tricare rescinded all payments. They have gone on national T.V. making it clear that they do monitor some sites and that they will flag and go after surrogate's to get any monies paid by Tricare reimbursed. Even getting things in writing from Tricare hasn't protected surrogate's. I would be very leary of trying to use them as primary insurance for a surro-pg.


Wow I didn't know this at all. I am no good when it comes to insurance, I guess reading wouldn't have mattered in this situation. LOL

#9 GSinIN

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Posted 12 January 2012 - 09:48 AM

Wow I didn't know this at all. I am no good when it comes to insurance, I guess reading wouldn't have mattered in this situation. LOL


Yep, happened to me! At 19 weeks, they rescinded all payments and flagged my account. It was the last thing I wanted to deal with while pregnant. Even though I know they won't pay, since they are still my primary insurance, every charge has to go through them, they have to deny it, then I get billed. Pain in the butt.




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