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Tricare Standard - Maternity

bootsie08bootsie08
in Military Families

I just received yet another bill.....

Was your glucose test covered under the global maternity provision?  How about anemia?  As far as I know, these are very standard lab tests performed during every pregnancy.  At the same appointment I also had a urine test to check for a bladder infection.  I knew that I would possibly have to pay a co-pay for that test  because it's not directly related to the pregnancy, but I don't understand why I'm being charged a co-pay for the GD and anemia tests. 

Just curious to see what others have experienced before I spend an hour on hold with Tricare.  TIA.  

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Re: Tricare Standard - Maternity

  • seastar77seastar77
    I got a statement from Tricare Standard saying some dollar amount had been applied toward the deductible, and I assumed it was for some of the lab tests, but I have yet to receive a bill from the hospital/lab. That was around the time of my triple screen and initial blood work. Haven't heard anything after UTI, anemia, PIH or glucose labs. I don't really pay attention though because we're going to hit our cap before the LO gets here just with my DD's medical bills, so whatever I do/don't get charged, in the end it's going to cost me the cap. I do know you'll have to pay some of the delivery (not much - $300ish??) and hospital stay (it's about $17/day) on Standard. Call and talk to them, though. Tricare is SO confusing. (On the plus side, after reading some of the insurance posts over in 3rd Tri where people are paying $3-6K or more for births, I am realizing what a really great value Tricare is! Well, you know, if you don't count the "cost" of servicemembers' 16 hour workdays and year long deployments that earn us Tricare...)
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  • shall923shall923 member
    I didn't pay that much for delivery. I had an emergency c-section and the total bill was over $17,000. It only cost us $63. It was definitely worth getting to pick my doctor and hospital. I know when I was pregnant I would pay small amounts here and there but never more than $8 from what I remember. I had a thyroid problem so I got blood drawn a lot. 
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  • ladybug8510ladybug8510
    I haven't paid anything yet for my L&D.  I was on a different insurance for the glucose test though.  I do know I didn't pay anything for the strep b test which I was on Tricare for. 
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  • bootsie08bootsie08

    Thanks for the input.  I talked to Tricare and, as usual, they say it is coded incorrectly - as a regular office visit instead of maternity.  I don't understand, though, how everything else from that visit (the actual doctor visit, doppler, etc) was coded as maternity and the lab work was not.  I've been having issues this entire pregnancy with this billing office.  They seem to know how to work around the Tricare system and stick me with charges that Tricare won't allow (like "excess paperwork" fees, but say I have to pay because I signed a statement agreeing to pay anything that wasn't covered.

    As far as L&D, I was told the only charge would be a daily room charge.  Everything else should be covered 100% - no co-pay or deductible - so long as it is medically necessary and allowable charge. 

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  • DuckLoverDuckLover

    I only paid my deductible twice (two different fiscal years) and $110 and some change for the delivery.  That included a failed induction and when I actually gave birth via CS.

    The bill for my CS and DS' 6 hours stay in the NICU where I delivered was $35,000.

    Even for his 2 hospital stays I haven't paid a penny for him and he's over $500k.

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  • Temp76535187505890Temp76535187505890
    I paid $92 for some lab tests but have no idea which ones because I didn't bother looking. For the actual delivery (at a hospital birth center) I only paid the admitting fee of $25. Whoever it was that had to pay $300 should be upset!
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  • seastar77seastar77

    imageArmyQM:
    I paid $92 for some lab tests but have no idea which ones because I didn't bother looking. For the actual delivery (at a hospital birth center) I only paid the admitting fee of $25. Whoever it was that had to pay $300 should be upset!

    Don't worry, I didn't actually pay that, I was just saying I thought it was the charge Tricare told me, but I could be wrong. I didn't pay close attention because I know I'll be hitting my fiscal year cap before the baby arrives anyway.

    imagebootsie08:

    They seem to know how to work around the Tricare system and stick me with charges that Tricare won't allow (like "excess paperwork" fees, but say I have to pay because I signed a statement agreeing to pay anything that wasn't covered.

    That's terrible! I've never heard of a Dr's office being so sneaky. I'd definitely complain. There are plenty of us who are high risk, etc, and have "extra paperwork" and don't get billed. But considering Tricare DOES cover all the extra pregnancy tests like glucose, it's really bad that they want you to pay out of pocket instead of taking the cut they agreed to when they affiliated with Tricare. Is there some way to report them?

     

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