Learning the military health care system can be overwhelming as a new spouse, including whether Tricare covers birth control. But some things can't wait, like continuing your prescriptions from before you were married or getting started with a new one. If you're on birth control or want to be on birth control, here's what you need to know.
How do you get birth control from Tricare?
Once you're enrolled in the Defense Enrollment Eligibility Reporting System (DEERS) and have an ID card, you can make an appointment to see your primary care manager (PCM). If you have Tricare Prime, you're seen on the installation, in most cases. You can make an appointment by logging onto TricareOnline.com or by calling your local appointment line. If you have Tricare Select, you can choose a provider and give their office a call.
Sometimes, getting an appointment with your PCM is easy; sometimes, it's difficult. You can increase your chances if you say you're open to seeing any provider. Birth control is prescribed for many reasons, not always to prevent pregnancy, and there is no minimum age listed in the Tricare policy for prescriptions, said Eileen Huck, deputy director for health care at the National Military Family Association.
Huck also said there is nothing in the policy about informing parents or sponsors of underage dependents receiving a birth control prescription, which aligns with the rules in place to safeguard patients' rights under the Health Insurance Portability and Accountability Act (HIPAA).
Some spouses have run into resistance when requesting birth control from their provider. Huck says this in response, "Birth control is a covered Tricare benefit. If a provider does not want to prescribe birth control, the spouse has the right to see another provider and request it."
What birth control does Tricare cover?
Tricare covers other birth control methods prescribed by a Tricare-authorized physician. These include diaphragms, intrauterine devices (IUDs), implantable contraceptives and surgical sterilization.
Tricare also covers the Preven Emergency Contraceptive Kit, which includes special doses of regular birth control pills and a pregnancy test. It also covers nonprescription emergency contraceptives such as Plan B.
As a general rule, it does not cover condoms, nonprescription spermicidal foams, jellies or sprays, or the reversal of surgical sterilization. Exceptions are made in cases where it's medically necessary.
Is birth control free under Tricare?
Birth control follows the line of other prescriptions from Tricare. There's no cost to fill your prescriptions from a military pharmacy. But that can be a pain, and there are other options.
If you take your prescription to an off-base pharmacy within the Tricare network, you'll have a copay, which ranges from $13 for generic formulary drugs for a 30-day supply to $33 for brand-name formulary drugs. If you go to a non-network pharmacy, you pay full price.
If you use home delivery, for a 90-day supply of generic, you'll pay $10; for brand-name, it'll be $29. These alternative options for your prescription can be helpful if you don't want to wait in the pharmacy on base.
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