Tricare and pregnancy test? — The Bump
Military Families

Tricare and pregnancy test?

This may be really stupid, please forgive me. I hate Tricare and wish it wasn't such a headache. I have Tricare Prime at a small base (no MTF, its just a clinic) and i know that for scheduling appts i have to get a referral before going off base. But do i have to when it comes to peeing in a cup or blood test to confirm a pregnancy?

Over the weekend i took 2 HPT that were BFP!! And i called the base clinic this morning to see about doing the official test and they said i have to be at least 5 days late w a positive HPT. Well AF isnt expected until tomorrow. Do i have to wait or can i go off base? Also, how does choosing your OB work with Prime? I know i have to go off base with prenatal care, but do i have to get my PCM to refer me off base to a OB or can I just call them myself? 

  Again, sorry if this is stupid. but

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Re: Tricare and pregnancy test?

  • With Prime, the PCM has to refer you to the OB.  They will generally get enough referral appointments to cover the pregnancy and the 6 week postpartum appt.

    Unless you want to pay, you'll have to wait the requested waiting period.  Unless you have a history of miscarriages, most OBs wont see you until 8-10 weeks anyway, so if you go now you'll just be waiting for the OB appt. 

    HTH.

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  • It may work slightly different depending on the base, but here's my experience. I called after BFP and they told me to come in for a blood test. They confirmed the pregnancy and gave me a list of providers I could choose from off base. The person that dealt with OB referrals on base was out that week so they told me to go ahead and make an appointment with someone on the list. Then I had to call the base clinic after I made my appointment to get the referral going. As far as I know, TriCare Prime won't cover your OB appointment unless you have a referral. I had to go into the clinic and pick up a hard copy of my referral before my OB appointment. I hope that helps. Honestly I prefer having to go in for everything referral related because the referral office here is terrible about calling back and actually getting things done. 

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  • Thanks ladies!! I guess I will until the end of the week. Its going to be hard tho. 
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  • It's different from base to base. I wasn't any days late....I expected AF that day, and they had me come in that day to do a pee test to confirm pregnancy since I got a positive on a HPT. The base hospital where I am doesn't do blood tests to confirm just pee.
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  • .I do you know you need to see your PCM for any type of referral, but I was under the impression that I would just see an OB on post at the hospital OB clinic.

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  • I had tested a week before I went to the clinic to get confirmation but the clinic here doesn't require you to be so many days later either.  I had done prior research to find a local OB that would suit my needs for this pregnancy and asked for the referral accordingly. 

    You can also check the referral process online as well. Once it's electronically processed you can call the doctor then verses having to wait for the paper copy.  http://www.humana-military.com/south/bene/beneficiary.asp

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  • Just wait and get the referral or tell them you are late or dont know when your period is supposed to come and get the referral. you need a referral though

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  • I had to have a BFP or be 2 weeks late before I could use the pregnancy clinic. I had a blood test, then attend an OB orientation class. We needed to fill out paperwork, got Rx for prenatals and pick our off base OB. Then it took a few weeks for the referral to come.
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  • image walkerb4:

    With Prime, the PCM has to refer you to the OB.  They will generally get enough referral appointments to cover the pregnancy and the 6 week postpartum appt.

    Unless you want to pay, you'll have to wait the requested waiting period.  Unless you have a history of miscarriages, most OBs wont see you until 8-10 weeks anyway, so if you go now you'll just be waiting for the OB appt. 

    HTH.

     

    This 

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  • Thank you for all the responses! I do have irregular cycles and often dont know when to expect my period, but i'm charting my BBT and know when i O'd so i know when i should get my period.

    Last time i had to wait for the paper referral to get to the Dr office it took about a month! And then they didnt have any openings for 3 months!! So hoping its not like that this time! 

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  • image jags09:

    I had tested a week before I went to the clinic to get confirmation but the clinic here doesn't require you to be so many days later either.  I had done prior research to find a local OB that would suit my needs for this pregnancy and asked for the referral accordingly. 

    You can also check the referral process online as well. Once it's electronically processed you can call the doctor then verses having to wait for the paper copy.  http://www.humana-military.com/south/bene/beneficiary.asp

    It varies from place to place whether they will make you wait or not.  Some places do and some don't.

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  • I think it all depends on the base you are at.  We are at Offutt and all I had to do was call and say that I had taken two home pregnancy tests and they then allowed me to go into the lab on a walk in basis for the lab work.  Following that, my husband and I were allowed to register for the required pregnancy course at the clinic and then I was able to get appointments set up for my pregnancy.  As for the OB, a lot of the PCMs at Offutt's clinics are also OBs.  I was lucky enough that my PCM is one of those so I haven't had to get used to a new doctor for the pregnancy. Here all referalls have to come from either your PCM or the Clinic appointment line or Tri-care won't cover it.
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  • We just have a clinic also and they have walk in hours for preg tests. They should give you paper work about what the next step to take is if your test come back positive. We had to go to an ob class on base and then got the referral in the mail. We have 2 obs they use in town so they just assign you one and you call for your appointment. I never had to talk/ deal with tricare directly but each base may be different. GL!
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  • It shouldn't take that long to get a referral. I go to my PCM off base, but it only took like 72 hours for the referral. I didn't get in the mail for awhile, but I called TriCare and they confirmed the referral had gone through. They had faxed a copy to my OB provider.  I was able to make an appointment the same week I asked for my referral(I did get referred to the OB clinic on base since I'm at a large base, but I imagine it would work the same way to get an off-base referral).

     Most OBs won't want to see you until 10 weeks anyway, so you might have to wait. If you're that anxious, just say you have a positive test and aren't sure when your period should come. My PCM gave me a blood test and pee test within 3 days of my positive HPT, I didn't have to be a certain number of days late.

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