The inability for some service-connected veterans to create a family of their own has long been a subject of frustration, helplessness, domestic tension and possibly even shame, among other feelings, for many of our members and other service-connected veterans. Until recently, the Department of Veterans Affairs (VA) provided few infertility services other than in vitro fertilization (IVF) to veterans as part of the medical benefits package.
In February 2017, the VA began offering IVF to eligible veterans and their spouses through participating community health care providers. In Section 260 of the Continuing Appropriations and Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017, and Zika Response and Preparedness Act (Public Law 114 – 223) it states that the VA may use appropriated funds available to VA for the Medical Services account to provide fertility counseling and treatment using assisted reproductive technology (ART) on a covered veteran or the spouse of a covered veteran, or adoption reimbursement to a covered veteran. This rulemaking expands the types of ART treatment available to certain veterans and makes fertility counseling and treatment including ART treatment available to spouses of those veterans, consistent with the statutory authority. NOTE: Reimbursement of adoption expenses are subject to a separate rulemaking.
Public Law 114 – 223 eliminated the inconsistencies between the Department of Defense (DoD) and the VA; specifically, IVF, along with a wide range of services that the VA considers as fertility treatment. Under this statute, VA is authorized to provide ART benefits, consistent with DoD policy guidance, to a veteran with a service-connected disability that results in the inability of the veteran to procreate without the use of fertility treatment, as well as the spouse of that veteran. The legislation stated that the implementing guidance developed by the Secretary shall not be materially different from, and in no way more expansive than, DoD’s policy, Joint Explanatory Statement, 162 Congressional Record at S6011 (2016). The IVF services available to veterans by the VA are the same as those provided by DoD.
The VA and DoD look at the providing of this service as a treatment for “a service-connected disability that results in the inability of the veteran to procreate without the use of fertility treatment.” means, for a male veteran, a service-connected or illness that prevents the successful delivery of sperm to an egg; and for a female veteran with ovarian function and a patent uterine cavity, a service-connected injury of illness that prevents the egg from being successfully fertilized by a sperm. This definition parallels requirements in DoD policy guidance for an active duty service member who is seriously or severely ill/injured (Category II or III) to receive fertility counseling and treatment using ART.
The Joint Theater Trauma Registry (JTTR) reflects the most common single cause of battle injuries is explosive devices (36.3%). Such trauma frequently results in genitourinary injury. For example, 1 in 5 warriors were evacuated from Operation Enduring Freedom (OEF) combat in October 2011 with a genitourinary injury. “The timing of this change is important, when considering the age of the veteran and their spouse, as that has a factor in successful fertilization and completion of a pregnancy, as delay may result in some veterans or spouses losing fertility potential prior to a later effective date.”
The following are some questions to consider regarding this treatment:
- WHO IS ELIGIBLE TO RECEIVE THE IVF BENEFIT THROUGH VA?
Veterans with service-connected conditions that have resulted in infertility, and their spouses, may be eligible for IVF coverage. Veterans interested in IVF must schedule an evaluation at their local VA medical center to obtain a referral to a community care provider. MALE and FEMALE veterans can contact the Women Veterans Call Center at 855-829-6636 for more information.
- IF VETERANS ARE SEEKING IVF SERVICES BUT DO NOT HAVE A REFERRAL FROM THEIR LOCAL VA MEDICAL CENTER, WHAT SHOULD YOU DO?
Advise them to locate the nearest VA medical center to schedule an initial evaluation to assess their eligibility and obtain a referral. The veteran can also call the WV Call Center at 855-829-6636.
- WHEN DOES THE IVF BENEFIT TAKE EFFECT?
The benefit is currently effective.
- HOW LONG WILL COVERAGE BE AVAILABLE?
Legislation previously authorized the IVF benefit through September 30, 2018, and was recently extended two additional years or until September 30, 2020.
- CAN IVF TREATMENTS BE COVERED RETROACTIVELY?
IVF services must be authorized by VA in advance. Veterans and their spouses cannot be reimbursed for treatments they received without a VA medical center referral and authorization for IVF.
- WHAT OTHER INFERTILITY COUNSELING AND TREATMENTS ARE COVERED BY VA?|
VA’s medical benefits cover infertility assessments, counseling, and certain treatments, such as hormonal therapies, surgical correction, and artificial insemination.
- HOW MANY IVF TREATMENT CYCLES DOES THE BENEFIT COVER?
Veterans and their spouses may be eligible for up to three IVF treatment cycles. Coverage is determined case by case, based on completing an evaluation at a VA medical center.
The preceding was adapted from an original work composed by Paralyzed Veterans of America Senior National Service Officer, Tony Timmons, located at the Columbia, South Carolina Service Office.
For more legislative news about in vitro fertilization, please visit www.pva.org/about-us/paralyzed-veterans-of-america-applauds-congress