Pregnant on Tricare Prime Remote — The Bump
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Pregnant on Tricare Prime Remote

Just found out we are barely pregnant! DD will be 4.5 years old; a little later than we had hoped, but deployments mess with your timing, right? DH had looked into a local fantastic birthing center when he enrolled us for Tricare Prime Remote and thought it was covered, but last week he said we're not. Ugh. I don't mind paying out-of-pocket for a doula, but if he's right (haven't looked into it myself), I think it's so ridiculous that Tricare will pay thousands to an MTF or hospital, but not for a much less expensive birthing center with no interventions! I need to buckle down and see if there are any workarounds or maybe if there is a birth center with a hospital affiliation. I think Tricare likes that as they see it as lower risk. Whee!
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Re: Pregnant on Tricare Prime Remote

  • Have you checked to see if they take Tricare Standard?

    It isn't about what Tricare will cover - it is whether the birthing center accepts Tricare.  Tricare does cover midwives and birthing centers if they are in the network (take the insurance).  The closest birthing center to us (90 minutes away) takes Tricare and I have had friends use it and have coverage.  I have also had friends have home births in base housing with midwives and they are covered by Tricare.

    We are stationed at a more remote base (they have a MTF clinic but OB care and most specialty care is civilian only) and I have found that many many more doctors take Standard than Prime.  I personally prefer Standard because I don't have to deal with my PCM every 5 minutes to get a referral for every little thing. 

    I would call the center and talk to their billing person.  See if they accept any forms of Tricare.  If not, ask if they can recommend another center. 

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  • I submitted an info form to the center yesterday and mentioned that I can switch to a different Tricare if that will make a difference. With Standard you pay a %, right? We chose Prime Remote when we PCSed here, but we weren't pg at that point. :) I guess I can switch at any time, but I should make an appointment with my PCM to get the initial appt., I guess.

     

    I'll look to see who is in-network  on the website, although I find that their search function can be weird as far as location. Thanks for the reply!

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  • The website can be outdated (especially the feature where they tell whether they are taking new patients).  If I were you I would research local doctors and birthing centers (word of mouth from friends, local co-workers, etc) and then prioritize where YOU want to deliver.  Then call them directly to discuss what insurances they take.  If you find a place that you love that only takes Standard - switch.  But who knows, you might find a great place that takes Prime Remote too.

    With Tricare Standard you do not pay anything for OB care during pregnancy.  So you would be covered the same way you would be with Prime Remote.  It is just for everything else that you would have to pay...  $150 deductable and then 20% until you reach your $1000 catastrophic cap.  After that cap you are covered 100% just like with Prime.

  • imageLithigin:
    Just found out we are barely pregnant! DD will be 4.5 years old; a little later than we had hoped, but deployments mess with your timing, right? DH had looked into a local fantastic birthing center when he enrolled us for Tricare Prime Remote and thought it was covered, but last week he said we're not. Ugh. I don't mind paying out-of-pocket for a doula, but if he's right (haven't looked into it myself), I think it's so ridiculous that Tricare will pay thousands to an MTF or hospital, but not for a much less expensive birthing center with no interventions! I need to buckle down and see if there are any workarounds or maybe if there is a birth center with a hospital affiliation. I think Tricare likes that as they see it as lower risk. Whee!


    I'm confused because if you go to www.tricare.mil and select Tricare Prime Remote and look under "Costs" it says: "Maternity Care (Office visits for delivery planned at home or another setting) $0" and "Maternity Care (Office visits for delivery planned in a TRICARE-authorized birthing center) $0" So I would assume if they accept Tricare Prime Remote it would be covered in full by Tricare. I could be wrong though.
    New little one arriving in June 2015!
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