Tricare Standard Question — The Bump
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Tricare Standard Question

I am new to tricare and until March 1 I am under tricare standard, and then I will be switched to Prime. I am 10 weeks pregnant and have not been seen by an ob since I got a 5w5d ultrasound at a clinic for pregnancy confirmation. If I am seen this week they said i have to pay a $150 deduct. plus 15% of the costs of the appointment. If i wait to get my referral with tricare prime i wont have to pay anything and can still be seen anywhere i want because we live far from post. Any advice? should i go ahead and be seen and pay since Im already 10 weeks or should i wait. thanks ladies!!
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Re: Tricare Standard Question

  • We just moved from one coast to the other. In the process, we had to change Tricare areas, so we had to go through enrollment and everything all over again. My last OB appointment was at 12 weeks 3 days. I won't be seen again until 20 weeks 2 days because that's how long it took to get everything sorted out and get an appointment.

    I say if you haven't had any problems and you'll be enrolled in Prime soon you should wait. But if it's worth it to you to pay for the peace of mind, there's nothing wrong with that. 

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  • do you have prime or standard? are you seen on post? i have no idea about how much this stuff would cost, do you? TIA!
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    No one else will ever know the strength of my love for you... After all, you are the only one who knows what my heart sounds like from the inside.

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  • imagepingalingalong:
    I am new to tricare and until March 1 I am under tricare standard, and then I will be switched to Prime. I am 10 weeks pregnant and have not been seen by an ob since I got a 5w5d ultrasound at a clinic for pregnancy confirmation. If I am seen this week they said i have to pay a $150 deduct. plus 15% of the costs of the appointment. If i wait to get my referral with tricare prime i wont have to pay anything and can still be seen anywhere i want because we live far from post. Any advice? should i go ahead and be seen and pay since Im already 10 weeks or should i wait. thanks ladies!!

    So probably it will be the best for you to wait. I just dont quite get it because Tricare Standard covers all pregnancy related appointments,blood test,ultrasounds etc.  I am 27 weeks now and I didnt have to pay for one single appointment I had and I am seen off post. You just definitely have to make sure that your doctor writes pregnancy care on his or her claim and Tricare Standard covers 100 %.

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  • imagepingalingalong:
    I am new to tricare and until March 1 I am under tricare standard, and then I will be switched to Prime. I am 10 weeks pregnant and have not been seen by an ob since I got a 5w5d ultrasound at a clinic for pregnancy confirmation. If I am seen this week they said i have to pay a $150 deduct. plus 15% of the costs of the appointment. If i wait to get my referral with tricare prime i wont have to pay anything and can still be seen anywhere i want because we live far from post. Any advice? should i go ahead and be seen and pay since Im already 10 weeks or should i wait. thanks ladies!!

    So probably it will be the best for you to wait. I just dont quite get it because Tricare Standard covers all pregnancy related appointments,blood test,ultrasounds etc.  I am 27 weeks now and I didnt have to pay for one single appointment I had and I am seen off post. You just definitely have to make sure that your doctor writes pregnancy care on his or her claim and Tricare Standard covers 100 %.

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  • Oh and COngratulations on your pregnancy and all the best!
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  • i will have to speak with them again. Everyone is saying that they dont pay with tricare standard, so im hoping i was just told wrong. thank you for the help ladies!! and gl with your pregnancies!!
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    Pregnancy Quotes BabyFruit Ticker

    No one else will ever know the strength of my love for you... After all, you are the only one who knows what my heart sounds like from the inside.

  • If you have to pay, I'd say wait a few weeks for Prime, but I have Standard and I haven't paid anything for OB at all regardless of the deductible. So like the PPs, I don't think you'd be charged to start care now on Standard, especially if you're going to stay with the same OB on Prime.
  • imageseastar77:
    If you have to pay, I'd say wait a few weeks for Prime, but I have Standard and I haven't paid anything for OB at all regardless of the deductible. So like the PPs, I don't think you'd be charged to start care now on Standard, especially if you're going to stay with the same OB on Prime.

    When did you have to pay the deductible and how much was it? I am with Tricare since December and so far I havent paid anything yet but I still dont quite get the stuff with the deductibles.

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  • Tricare Standard covers all pregnancy related appts, medically necessary ultrasounds, L&D for no cost.  I had a high risk pregnancy (with at least 20 ultrasounds) and my cost for the entire things including my hospital stay was $25.  And this was for my one night in the hospital (the cost was actually $15 but Standard has a $25 billing minimum for overnight hospital stays).

    So whoever told you that you would have to pay your $150 deductible and 20% per appt. is wrong.  That is for non-OB related care. 

    Not that you asked, but I would stay on Standard.  I have been a military spouse for 8 years now and think Tricare Standard is the best kept secret in the military.  For some reason everyone is so scared of it.  But it gives you wonderful freedom and choices for what IMO is very little cost. 

  • imagesweetheart18:

    So whoever told you that you would have to pay your $150 deductible and 20% per appt. is wrong.  That is for non-OB related care. 

    Not that you asked, but I would stay on Standard.  I have been a military spouse for 8 years now and think Tricare Standard is the best kept secret in the military.  For some reason everyone is so scared of it.  But it gives you wonderful freedom and choices for what IMO is very little cost. 

    thank you for the information! The people at tricare are the ones who gave me that info... I am going to an OB that takes tricare tomorrow, will they already be aware of this or will they make me pay? should i contact tricare again prior or just not worry about it? The only reason I am on prime is because my husband is, I will think about keeping standard, i have to get more info on it because im new to it all.

    Pregnant Quote Graphics from dolliecrave.com
    Pregnancy Quotes BabyFruit Ticker

    No one else will ever know the strength of my love for you... After all, you are the only one who knows what my heart sounds like from the inside.

  • I had DS on standard and loved it.  I paid my $150 deductible and $110 I think it was.  I was in the hospital for a total of 8 days I think.  Some of those were from my failed induction. 

     

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