Update on contraceptives and tubal ligations

November 18, 2022

Effective July 28, 2022, medical contraceptive consultations and services are considered integral parts of a well-woman exam, whether provided during an initial or subsequent visit, and provided without cost-sharing. Medical contraceptive services include injections, placement and removal of Intrauterine Devices (IUD), implantable rods and diaphragm measurements and fittings. There is no requirement that a well-woman exam, Health Promotion (HP) and Disease Prevention (DP) exam, be rendered in connection with a covered cancer screening or immunization.

Prescription contraceptives, including diaphragms received in a pharmacy setting, and prescription contraceptives used as emergency contraceptives, are also covered. Note: Implantable prescription contraceptives are covered if the US Food and Drug Administration (FDA) approved and used for the labeled indication.

Effective January 1, 2023, tubal ligation procedures are covered with no cost-sharing for TRICARE Prime and TRICARE Select beneficiaries when performed by an in-network provider. However, cost-sharing may apply when performed by an out-of-network provider.

TRICARE Policy Manual Chapter 7, Sections 2.1, 2.2 and 2.3

TRICARE Manuals - Display Chap 2 Sect 2 (Change 58, Apr 20, 2021)