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Tricare Question: PCMs & Pediatricians
I am totally new to this kid thing and I don't have any military friends with kids to ask. Do we get a pediatrician (on base or off base) or do just take the baby to our PCM?
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Re: Tricare Question: PCMs & Pediatricians
Depends on where you deliver. I am delivering at a civilian hospital even though we have Tricare Prime. The closest military hospital is 90 minutes away from us. The tricare rep that I talked to told me to pick a Tricare authorized pediatrician that was affiliated with my hospital and have that pediatrician do the initial checks at the hospital and LOs first appointment. She then told me that after we get a birth cert and SSN and LO is in enrolled DEERS we would have to see if we could keep the civilian ped or transfer to the military ped at the closest satellite clinic.
Clear as mud? Was for me too.
It will all depend.
You'll need to call Tricare and see if there are Military Treatment Facilities in your area. If there are, and there is an opening, he'll be sent to the MTF.
If there aren't MTF's or if your MTF is at capacity, you'll be allowed to see an in-network civilian provider.
Our MTF is full, so DD and I both see civilian Dr's. We'll get a waiver to make sure DD and DS get to see the same civilian Dr if there's room at the MTF when we enroll him. We don't want one child at the MTF and the other at another Dr.
This is for Prime. For Standard, you can choose your own in-network provider for your baby.
Bloggin' It
You said that so much better then my attempt!
LOL, just what I was expecting.
We are prime. I am going off base because I am high risk and will also deliver off base since we don't have a hospital here. I'll call Tricare tomorrow and start asking questions.
Tricare should (I would say "will", but Tricare can be a PITA and do strange things sometimes) cover whichever Pedi comes to the hospital to check your LO out after birth.
Our Pedi doesn't have privileges at the hospital I am delivering at, so the on-call Pedi will be in charge of baby boy's care. The on-call Pedi's aren't Tricare network providers. Tricare has assured me this is covered under my global OB care/hospital stay. We'll see if that holds true.
Bloggin' It
Like every else said, it depends. If you DON'T want your baby to go on base, you can always choose Tricare Standard. Our MTF lost their pediatrician right after my son was born and I wasn't comfortable having him see a regular doctor so we opted out of Prime. If I lived one town over Prime would approve the civilian ped but our zip code is just inside the line. The costs with Standard are still VERY reasonable and I love having the kind of access I get at a local pediatrician's office.
And remember, for the first 90 days you can take the baby ANYWHERE you want (that accepts Tricare), since they're automatically Prime, so if you're unsure if you want to see a civilian or your PCM I recommend at least test driving a civilian.
It should be covered, we had DD off base since there was no hospital on base, she saw the on-call pedi while we were there and for a intial visits after she was born, she then went to the base pedi for her 1month check up and every check up after that.
All pedi visits should be covered under your intital care until they are enrolled in DEERS or 30 days is over.