The Defense Health Agency developed this digital toolkit to help you communicate with beneficiaries about contraceptive care with TRICARE. This comprehensive communication campaign focuses on raising awareness of contraceptive options as well as drawing attention to recent copayment waivers.
Background
TRICARE provides beneficiaries with contraceptive care coverage. Access to comprehensive contraceptive counseling is critical to address the timing and choice regarding family planning and prevention of pregnancy. It’s also integral to addressing other medical conditions, and the management and suppression of menstruation.
To increase contraceptive choices, TRICARE is waiving copayments and cost-shares on medical contraception such as long-acting reversible contraceptives (LARCs) and permanent contraception. This toolkit aims to inform TRICARE beneficiaries on the improvements to contraceptive care and increase beneficiary choices of type and form of contraceptive care available.
What's Changing?
Effective July 28, 2022, copayment and cost-shares were waived for long-acting reversible contraceptives.
- Phase 1: Copayments and cost-shares for long-acting reversible contraceptives services such as placing and removal of IUDs, contraceptive shots, and subdermal contraceptive rods will be waived beginning Nov. 1, 2022.
- Phase 2: Copayments and cost-shares for tubal litigation, a form of permanent contraception, will be waived for TRICARE Prime and TRICARE Select beneficiaries beginning Jan. 1, 2023.
Beneficiaries who are charged a copayment when they receive these procedures between July 28, 2022, and the implementation date have to pay applicable copayments or cost-shares at the point of care. However, beneficiaries may request reimbursement any copayments or cost-shares by having their claims reprocessed after the appropriate implementation date.
Beneficiaries should talk to their doctor or primary care manager about what contraceptive care is available to them and how to receive it. More information on TRICARE coverage of contraceptive care can be found at www.tricare.mil/birthcontrolTRICARE webpage.
Talking Points
Senior Leader Talking Points - Copayments Only
- Easy, convenient, and timely access to the full range of contraceptive methods and counseling is a goal of the Military Health System (MHS).
- TRICARE covers a full range of contraceptive methods for beneficiaries.
- As of July 28, 2022, contraceptive medical consultations and services are considered part of preventive health exams. This means that TRICARE beneficiaries no longer have to pay a copayment for the following long-acting reversible contraceptive services:
- Injections
- Placing and removing of intrauterine devices (IUDs)
- Placing and removing of implantable rods
- As of Jan. 1, 2023, cost-sharing for tubal libation is also waived for TRICARE Prime and TRICARE Select when performed by an in-network TRICARE-authorized provider. Cost-sharing may still apply for tubal ligations performed out-of-network.
- Beneficiaries my have to pay a copayment for pharmacy contraceptives, like birth control pills and patches, depending on where they fill their prescription.
- Cost-sharing amounts for prescription pharmaceuticals obtained outside a military hospital or clinic are set in law, and would require a statutory change to waive. However, prescription pharmaceuticals are available to all eligible TRICARE beneficiaries in military hospital or clinic at no cost.
- Beneficiaries can check the costs for their chosen method of contraception at tricare.mil/contraception
- Beneficiaries should talk to their doctor or primary care manager about what contraceptive care is available to them and how to receive it.
- Access to comprehensive contraceptive counseling is critical to address the timing and choice regarding family planning and prevention of pregnancy. It’s also integral to addressing other medical conditions, and the management and suppression of menstruation.
- According to the 2020 DOD Women’s Reproductive Health Survey, roughly 60 percent of both DOD and Coast Guard active duty service women reported current contraceptive use. Approximately three in ten were currently using a highly effective form of contraception.
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