Deputy Chief Of General Staff Uk
Micol Cohn
Soldiers may be granted an administrative absence from their normal duty station, without being charged leave, for a period of up to 21 days to receive, or to accompany a dual-military spouse or dependent who receives, non-covered reproductive health care.
The Army defines a covered abortion is an abortion, either medical or surgical, where the life of the mother would be endangered if the fetus were carried to term or in a case in which the pregnancy is the result of an act of rape or incest.
Active duty Soldiers, including Reserve or National Guard members when on active duty orders for 30 or more consecutive days, may request an administrative absence to access non-covered reproductive health care, or accompany a dependent to access non-covered reproductive health care.
An administrative absence can be requested when a Soldier needs to access, or accompany a dependent to access, non-covered reproductive health care so that they do not need to use chargeable leave. Soldiers who are already accessing ART through the Supplemental Health Care Program are not eligible as they are able to receive such care without using chargeable leave.
It is the responsibility of commanders or approval authorities to meet operational requirements and protect the health and safety of those in their care. Commanders or approval authorities are expected to display objectivity, compassion, and discretion when addressing all health care matters, including reproductive health care matters, and have a duty to enforce existing policies against discrimination and retaliation in the context of reproductive health care choices.
Commanders or approval authorities will not levy additional requirements on the eligible Soldier (including, but not limited to, consultations with a chaplain, medical testing, or other forms of counseling) prior to approving or denying the administrative absence request.
Yes. Soldiers on Active Duty may choose to request regular leave or special liberty instead of an administrative absence to access non-covered reproductive health care. Special liberty would be limited to no more than 4 days.
Am I eligible to request an administrative absence for non-covered reproductive health care or regular leave or special liberty to receive a covered abortion?
Soldiers who are eligible for a covered abortion may seek care at their local military medical treatment facility. Existing processes exist to fund travel for Soldiers who must receive covered care outside the local area.
No. Soldiers will not be granted an administrative absence to access non-covered reproductive health care if the intent is to sell, offer for sale, or receive proceeds from a sale resulting from an ART procedure.
This policy standardizes and extends the timeframe for Soldiers to inform their commanders about a pregnancy. Soldiers may now choose to delay command notification of a pregnancy until no later than the 20th week of pregnancy, except in certain circumstances. More information on this policy can be found at: www.health.mil/EnsuringAccesstoReproductiveHealth.
Soldiers are encouraged to access prenatal care as soon as they learn of their pregnancy to promote the health and well-being of themselves and their pregnancy. If a Soldier chooses to delay command notification of the pregnancy, they will be put on a limited duty status, but their pregnancy will not be disclosed, unless certain exceptions apply. This will ensure a balance between Soldier privacy, their health and well-being, and unit/mission needs. More information on this policy can be found at: www.health.mil/EnsuringAccesstoReproductiveHealth.
Soldiers will be provided the time and flexibility to make private health care decisions in a manner consistent with the responsibility of commanders to meet operational requirements and protect the health and safety of those in their care. Soldier who delay sharing their pregnancy status with their commanders will be placed on a limited duty status (as appropriate), as recommended by their treating health care provider. Additionally, there are some exceptions that may apply, based upon individual circumstances of the Soldier, a potential upcoming deployment, or unit hazards. These safeguards balance Soldier desire for privacy with their health and well-being, as well as unit and mission needs. To learn more about this policy, please go to www.health.mil/EnsuringAccesstoReproductiveHealth.
My position requires me to make mandatory notifications, such as those related to domestic abuse or sexual assault. Does this new pregnancy privacy policy prevent me from making such notifications?
There are military duties, occupational health hazards, and medical conditions where the proper execution of the military mission outweighs the interests served by delaying commander notification of a pregnancy. If the DoD health care provider makes the notification to a commander, the Soldier will be notified prior to the command notification except in exigent circumstances. A commander will be notified of a pregnancy prior to the 20th week if:
What resources are available to health care providers concerned about performing covered abortions at my military medical treatment facility because my current license is in a state with restrictive state laws?
Military and civilian health care providers working in military medical treatment facilities (MTFs) may request reimbursement to receive an alternate license when their current license is in a state where the provision of federally authorized health care is restricted.
Easy, convenient, and timely access to the full range of contraceptive methods and counseling is a goal of the Military Health System (MHS). To better facilitate access at military medical treatment facilities (MTFs), the MHS has implemented walk-in contraceptive services at every MTF with appropriate clinical capabilities. These clinics do not require appointments and are staffed with health care personnel who are trained in the full range of contraceptive methods, including short-acting reversible contraceptives (e.g., birth control pill, patch, or ring) and Long Acting Reversible Contraceptives (LARCs), such as intrauterine devices (IUDs) and implants.
Cost-sharing amounts for prescription pharmaceuticals obtained outside a MTF, including oral contraceptive pills, are set in law, and would require a statutory change to waive. However, prescription pharmaceuticals are available to all eligible TRICARE beneficiaries in a MTF at no cost.
Oral emergency contraceptives, such as Plan B and ella, are covered within DoD and by the TRICARE Pharmacy benefit. Plan B is available at MTF or network retail pharmacies without need for prescription and with no copay. Ella is available via prescription at MTF or network retail pharmacies (copay for non-Active Duty beneficiaries at retail only). For network retail pharmacies, the beneficiary (or a friend or partner picking up for the beneficiary) must provide documentation of patient identity and TRICARE eligibility, generally an appropriate ID card, in order for the pharmacy to process the TRICARE Pharmacy benefit claim. Plan B is also available for purchase in many Military Exchanges, pharmacies, and other local retailers.
DoD will continue to provide Plan B, ella, and other contraceptive care in MTFs, consistent with federal law, regardless of state law restrictions. If a state prohibited emergency contraceptives, we expect that private sector retail pharmacies operating in that state would comply with state law.
Does Army permit the mailing of emergency contraceptive pills through the TRICARE Mail Order Pharmacy Program to Soldiers, dependents, or other beneficiaries in states that restrict access? Does Army distribute emergency contraceptive pills to Soldiers, dependents, or other beneficiaries at MTFs in affected states?
Currently, emergency contraceptives like Plan B or ella are not available via mail-order pharmacy, given potential delays in receipt of medications via mail order. Mail order utilization is best served for chronic conditions and not acute conditions where timing of medications, such as emergency contraceptive, is critical.
The Military Health System (MHS) has the capability to perform both medical abortions (which are performed with medication) and surgical abortions, in cases where the life of the mother would be endangered if the fetus were carried to term or in the case in which the pregnancy is the result of an act of rape or incest.
Will TRICARE continue to provide coverage for abortion services in the case of rape, incest or when the life of the mother would be endangered? What if state law restricts my ability to receive an abortion?
However, military medical treatment facilities are still authorized to provide covered abortions, even when state laws restrict such care. When not available in the private sector, Soldiers and eligible beneficiaries may access care at a local military medical treatment facility or travel to the closest military medical treatment facility with the necessary capability. The following question outlines current processes for accessing covered care not available locally for beneficiaries. Beneficiaries seeking assistance with access to a covered abortion can contact -MHS/Contact-Us, for assistance.
When a covered abortion is not available in the local area, does DoD provide travel and transportation allowances for a Soldier or other health care beneficiary to receive a covered abortion? What is the process for requesting these allowances?
Complete care generally includes an initial diagnosis of pregnancy, counseling regarding pregnancy options, any necessary pre-procedural evaluation, peri-operative care (care provided around the time of a surgical procedure), contraception counseling and provision, screening for sexually transmitted infections, referral for mental health services, and follow-up/post-operative care as required. Sexual Assault Response Coordinators (SARCs) or the Family Advocacy Program (FAP) are notified by a DoD medical provider at an MTF if a patient informs the provider that the patient is a victim of a sexual assault so that the SARC or FAP can inform the victim of services and reporting options. There is no requirement that the health care provider inform the SARC or FAP that the patient requested an abortion. Health care provider communications to a SARC or FAP are confidential. As a result, if the patient has made, or desires to make, a Restricted Report, that option is not affected by health care provider notifications to a SARC or FAP.
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