How do I go about getting a Pediatrician? — The Bump
Military Families

How do I go about getting a Pediatrician?

**I tried to search for this question on this board but I didnt get anything. Im sorry if this has already been answered!**

Im on Tricare Standard and I see a civilian Dr. off base. I need to start looking into getting a pediatrician for our little girl and I have a few questions...

1)   I know that the baby is automatically covered for the first 60/90 days after birth, but is she automatically covered under Standard or Prime?

2)   Since Im on standard and seeing a Dr. off base, do I automatically look for a doctor off base or do I have to look for one on base??

Thanks!

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Re: How do I go about getting a Pediatrician?

  • 1) The baby is automatically covered under Prime for the first 60 days, BUT that doesn't mean you have to go on base.  You can take LO to a civilian pedi, and during the first 60 days you won't pay anything.  After 60 days, you have to enroll LO in Prime if that's what you want.  At that point, your DD would have to use the MTF unless she has a referral or is assigned a civilian PCM.  Or you can put her on Standard and continue to see a civilian pedi and start paying any required cost share.  My DS has never been seen on base.  We paid nothing for his care during the first 60 days, and after that have had minimal co-pays.

    2) Your Tricare enrollment is independent of LO's.  If you want to have your DD on Standard, I advise starting the search for a civilian pedi.  If you want to have her on Prime, you don't need to search and she will be assigned a PCM.

    Hilary
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  • Thank you SO much! That is exactly what I was looking for!
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  • The baby isn't actually on Prime. She is on Standard with Prime benefits for the first 60 days. That is how it was described to me by Tricare. She has to be officially enrolled in Prime to be Prime. After 60 days, she will lose Prime benefits unless she is enrolled. If you plan to keep her on Standard, find any doctor you want within the network. If you plan to enroll LO in Prime, you can still go to any doctor of your choice for those 60 days, but you will need to enroll her and be assigned a PCM.
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