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Another Tricare standard maternity question...
So I'm 4 1/2 months along, and the whole time I've had my primary insurance through my job and Tricare Standard secondary. I'll be quitting my job before the baby is born, so then I'll just be on Tricare Standard. I've looked all over the Tricare and HealthNet sites, and I'm finding conflicting information. So here's my questions:
-The OB office I see is a non-network provider that accepts Tricare, so I know normally I would have to pay the 20% co-pay, but would it be covered completely under the global maternity fee?
-If I do have to pay the 20% co-pay since they're non-network, does that also apply to the actual birth as well?
Thanks so much for the help!
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Re: Another Tricare standard maternity question...
My understanding is that the provider just needs to be Tricare authorized in order for Global Maternity rules to apply, which should be the case if your OB accepts Tricare. But I would double check with your OB's billing office to see if they have agreed to accept Tricare's maximum allowable amount. There is a little box they have to check on the claim forms that they submit. If they do not, the Tricare office should be able to clarify whether they can bill you the difference for maternity. For coverage other than maternity, non-network providers can bill you 15% above the maximum allowable charge in addition to co-pays.
Congratulations!
Thanks for the info!