TRICARE Question

LEP424

Hi Ladies! I'm new to this board, what a great discovery! My husband is transitioning from a Guard Technician slot to an AGR slot. We have to make a decision about insurance. After having a miscarriage last month, I feel very strong about wanting to stay with my OB who only takes Standard. I am scared of the 15% cost responsibility of Standard. What have your experiences been? Should I consider switching doctors to go with Prime Remote or staying with my own employer's insurance until we have a baby? I appreciate your responses!

chloebeth930

As long as your OB is a Tricare provider then you won't pay any out of pocket for maternity.  It is all covered under Global Maternity.  I think in the end you end up paying $16 for the hospital stay.

Now if your OB isn't a provider but takes Tricare then you will have the cost share.  It is capped at $1,000 OOP costs.

Lissa832

I switched to Standard midway through my pregnancy. I never paid a dime. I only paid $33 dollars for my delivery. You are capped at $1000/year, so the rest of your medical care is reasonable.

shall923

All pregnancy related charges will be free. If you have issues outside of a normal pregnancy or non-pregnancy related issues you will pay 15% of the tricare negotiated rate. I had extra blood work due to a thyroid issue. I also had 7 u/s done. Because of all that I had extra charges but they maybe totaled $50 for the whole pregnancy. I had an emergency c/s at one of the best hospital in my city and it cost me $63. It was so worth it to me.

LEP424

Thanks so much ladies, I really appreciate all the info. Most others in our unit are on the insurance offered through the state because of being guard, so I didn't have anyone to ask. Reading the info. is so confusing. Your responses are greatly appreciated. Have a nice weekend

marielovestimothy03

Ditto the others. My DH is in the reserves so we're on reserve select (which I believe is very similar to standard) and I haven't paid a dime OOP for this pregnancy - as far as I know I'll just be responsible for the $16/day in the hospital and any non-pregnancy related things if they should come up.

jlgregory75

If your husband is in the Guard or Reserves, then Tricare Reserve Select is an option. It's what we have and works very much like Standard. Out pocket costs have been low so far. We also do not require a PCM for referrals.