The military TRICARE insurance system can be difficult to maneuver.

There are many medical procedures that are covered for active-duty servicemembers and not covered for dependents. On its website, TRICARE says that its insurance "covers most inpatient and outpatient care that is medically necessary and considered proven. However, there are special rules or limits on certain types of care, while other types of care are not covered at all."

The definition of medically necessary can be different from person to person, but there are some hard rules for certain procedures. For instance, many servicemembers are eligible for LASIK corrective eye surgery, which can be confusing when a spouse or child is denied coverage for the same procedure.

Laser-Assisted In Situ Keratomileusis (LASIK) is a procedure in which a flap is cut in the top of the cornea. Underlying corneal tissue is removed with a laser, and the flap is put back in place. LASIK is used to correct myopia (nearsightedness) and hyperopia (farsightedness) as well as astigmatism and presbyopia.

Another popular corrective eye surgery is Photorefractive Keratectomy (PRK). Both surgeries are elective for military dependents and not covered under TRICARE. If a military dependent would like to receive either procedure, he or she must cover the costs out of pocket.

There are multiple businesses within the South Sound area that perform both LASIK and PRK procedures, such as Cascade Eye and Skin Center, which has five local clinics, Pacific Northwest Eye Associates in Tacoma, and Clarus Eye Center in Lacey. The corrective procedures average $1,500 to $2,000 per eye.

Another area of TRICARE coverage confusion is with infertility treatments. While TRICARE offers some of the best prenatal-related insurance in the industry, there are many limits when it comes to helping a patient get pregnant.

However, TRICARE may cover diagnostic services to identify illness or injury to the reproductive system, and infertility treatment for women - to include corrective treatment and surgeries - is covered.

Correction of male infertility often comes with a cost share for the man, but is determined on a case-by-case basis. Treatment for erectile dysfunction due to organic (versus psychological) causes, when determined to be medically necessary and appropriate, is also covered.

Hormonal treatment, corrective surgery, administration of Human Chorionic Gonadotropin (HCG), and radiation therapy are often covered for both genders.

In Vitro Fertilization (IVF) treatments are a bit harder to come by and can be very costly. TRICARE does not cover IVF, nor will it cover reversal of surgical sterilization (for both men and women).

However, there are four military clinics that offer IVF to military couples: Wilford Hall Medical Center in San Antonio; Tripler Army Medical Center in Honolulu; Walter Reed Army Medical Center in Washington D.C.; and the Naval Medical Center in San Diego.

The average cost of an IVF cycle ranges between $10,000 to $20,000 dollars.  The GYFT Clinic in Tacoma offers IVF as one of its services.

Insurance decisions are rarely ever cut and dry. There are often case-by-case denominators that may affect the outcome of the decision. Many procedures require a referral or prior authorization before being performed.

TRICARE recommends visiting the website (www.TRICARE.mil) or contacting a regional TRICARE Area Office for more information. TriWest Healthcare Alliance, which administers the TRICARE program in the West, services local TRICARE beneficiaries.

There are three local TriWest offices. The largest is inside the Madigan Army Medical Center in Room 2-56-33A. Another is located inside the JBLM Welcome Center in building 2140, room 204, and there is also an office on McChord at 690 Barnes Blvd.

To contact a TriWest customer service representative, call (888) 874-9378.