Tricare in general — The Bump
Military Families

Tricare in general

I'm 5 months pregnant and married to the army- i mean an army man ;) Already I see problems with this...not the man, but the army.
1) We went last week and signed me up for tricare so i can FINALLY see a doctor for the baby. The lady who filed the paperwork said we could call for an appointment right away. 3 days and a million phones calls later someone finally picked up the phone and told us it'll take 2 weeks to get my info in the system to even get an appointment.

2) We live in Baltimore Maryland, right outside city lines.  The closest army base to us is Fort Meade- which is a 30-45 min drive. We were told Fort Meade doesnt have an OBG on base...and due to the insurance I would have to go to Bethesda Naval Base to get my prenatal- a 2 hour drive at least in good traffic.

No one will pick up the phone to answer my questions- and my husband doesnt know enough to answer them for me. He's never been this far off a military base before.
Why can't I go to a civilian hospital? I understand military insurance= military doctor and i have no problem with that. But are they really going to require me to drive 2 hours for a doctors appointment when I'm literally 5 minutes from a hospital? What happens when i go into labor? Are they gonna force me to deliver in the car on my way to Bethesda Naval Base?


Why can't i get anyone to answer my questions? How difficult is it to pick up the phone?
My husband is going to Fort Lee VA for 2 months for training and I'm worried that everything that could go wrong will.  I dont know if anyone else on here has had the same problems...but I could definitely use some help here. 

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Re: Tricare in general

  • I'm Just south of you. I am switching to Standard for this reason entirely. The hospital that I have to deliver at is anywhere from 45 minutes to 2 hours depending on traffic. It just isn't feasible, IMO, to go through that. If you switch to Standard, your pregnancy will be covered 100%. you will pay a daily rate for your hospital stay. You will have to pay a copayment for any other types of appointments you have. The positive is that you get to choose your own doctor. I'm tired of driving 30 minutes to see my OB, when I can go to one 5 minutes away, and deliver at a hospital 10 minutes from my house. On a side note, are you recently married? If not, then why haven't you already enrolled and gotten the proper prenatal care? Waiting five months to see a doctor is entirely irresponsible, IMO.
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  • Recently married...I didnt realize my husband was enrolled in prime- How do i go about switching to standard??
    My insurance didnt cover the baby before- husband is in the middle of PCSing to Washington, but im staying in MD til after the babys born. Medicaid gave me the run around because I'm unemployed, by the time I was  excepted, we decided to just get married. I've had 1 doc appointment ...long enough to tell me how far along i was and that the baby looked good. But since I'm now married, i cant use my medicaid anymore.....and tricare is giving me the run around...saying my info isnt even in the system yet for me to set up an appointment. 
    I'm very frustrated with all this.....
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  • I don't know the specifics of that area, but if you're really 2-3 hours from the nearest base with OB's then you should be able to see a civilian OB while still on Prime. 

    Also, who are you trying to call?  I've heard of, and had, numerous problems with Triacare over the last 5 years, but I've never heard of not being able to get ahold of anyone (unless you're calling after hours?).  I don't think I've even had to wait on hold to talk to someone in any of the regions I've been covered under. 

  • It took me almost 4 days to get ahold of someone in the OBG office on Bethesda Naval Base using the number Fort Meade gave me to set up an appointment. Only for them to tell me my info wasn't in the system- that it could take almost 2 weeks for me to be in the system.
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  • Just call Tricare's 1-800 number for whichever region you're in to make sure you're in their system, and to see about going to a civilian OB that's closer.

    Also, if you did your Prime paperwork within the last week or two, you won't be officially on Prime until the next enrollment period (which should be May 1... April 1 if you did the paperwork at the beginning of the month).  It's not like Standard where you're on it the day you enroll.  That's probably what's going on since military hospitals only see people on Prime (at least as far as I know), so you wouldn't be in their system if you're still on Standard.  Just call Tricare, they can explain it all better than I can. 

  • when entered in deers you are automatically enrolled in standard and you phyisically have to change yourself to prime. tricare is retroactive to the day you are married so if you want to go to the doctor you can pay and submit your bills although I dont encourage this it is possible. Also it is a tricare rule that if you are more than 30 ish (cant remember the exact number) miles from an MTF they will assign you a non military pcm. I would call again and talk to someone who actually knows what they are talking about. Also I am by a MTF and not ONE person pregnant person I know sees a military doctor for their prenatal care and non of them will deliver at an MTF (it is also not IP). I would call again and get a better person

    Married 11/27/09 and TTC right away
    Dx: Complete septate uterus with cervical duplication, endometrial polyps, PCOS, endometriosis, hypo thyroid, luteal phase defect
    4 uterus surgeries to correct my complete septum and to remove polyps and 2 years of seeing the RE, medicated cycles and IUIs
    Baby 1 and 2: BFP 3/3/11 with 2 babies EDD 11/1/11, M/C 4/6/11
    Baby #3: 8/11 pregnant EDD 4/27/11 and m/c:(
    Baby #4: 10/12/11 BFP! EDD 6/16/12m/c 10/26/11
    Baby #5: 3/13/12 BFP! EDD 11/25/12 ANOTHER m/c :(

    Baby #6: 2/14/13- BFP! EDD 10/24/13, CP 2/19/13
    Baby #7: 3/15/13- BFP! EDD 11/27/13, another CP
    Baby #8.  BFP 5/19/13 EDD 1/22/14. 8 was not our lucky number

    4th septum resection on 5/31/13.
    Baby #9: 6/29/13 BFP. C section scheduled for March 5th!

    My miracle baby was born March 5 at 9:33am. He was 8 lbs 12.5 oz and 21.25 inches long!

    image"">

  • I went through the paperwork we were given at enrollment. We're enrolled in Tricare Prime....he was on it before we got married, and i guess that's what they put me on when I enrolled.
    We enrolled around march 23rd...so I'm guessing it'll be closer to may....i really cant wait that long.  Guess I'm gonna have to find the 1-800 number for this area.....
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  • Yep, any paperwork after the 20th of the month won't be officially enrolled until the 1st of the month after next (so May 1st you'll be in Prime).  You should be able to see doctors now, it'll just be covered under Standard so there may be a co-pay if Tricare requires a confirmation appointment (even though you obviously already know you're pregnant).  For any actual maternity care there shouldn't be any co-pays, even under Standard.  Again, talk to Tricare, but maybe see if you can find a civilian OB in your area that accepts Standard and is covered under Prime so you can try and get an appointment before May, but won't have to switch doctors. 

    Good luck! 

  • imageufsandra85:
    when entered in deers you are automatically enrolled in standard and you phyisically have to change yourself to prime. tricare is retroactive to the day you are married so if you want to go to the doctor you can pay and submit your bills although I dont encourage this it is possible. Also it is a tricare rule that if you are more than 30 ish (cant remember the exact number) miles from an MTF they will assign you a non military pcm. I would call again and talk to someone who actually knows what they are talking about. Also I am by a MTF and not ONE person pregnant person I know sees a military doctor for their prenatal care and non of them will deliver at an MTF (it is also not IP). I would call again and get a better person
    Unless things have changed in the last seven years, you are automatically enrolled in Prime, not Standard. Also, I live about 35 miles from the hospital I'm expected to deliver at. I'm at least 60-70 miles from the hospital (Bethesda) they'd send me to if I started to have issues. My understanding was that I would be referred out because of the distance. The MTF OB doesn't even show up on the Tricare website. However, it doesn't matter. No matter what, I will not be referred out. It is the policy in this area. The only way to be seen by a civilian here is to have Standard. It takes so long to get to these hospitals because the traffic here is insane seven days a week. I am going to have a chat with my OB tomorrow, but I know she won't refer me out, so I'm switching to Standard as soon as DH comes home from a short TAD trip.
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  • The day you got married you were covered under Tricare Standard so no you don't have to wait for your prime coverage to kick in before you can see a doctor. There might be some copays involved with Standard but you won't be on it long, just until your Prime coverage starts.

    If you're in Maryland, call this number 1.877.874.2273 (north region) to talk to a Tricare rep. They will not make you drive two hours to an MTF. You will see a civilian OB.

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  • imageLissa832:
    imageufsandra85:
    when entered in deers you are automatically enrolled in standard and you phyisically have to change yourself to prime. tricare is retroactive to the day you are married so if you want to go to the doctor you can pay and submit your bills although I dont encourage this it is possible. Also it is a tricare rule that if you are more than 30 ish (cant remember the exact number) miles from an MTF they will assign you a non military pcm. I would call again and talk to someone who actually knows what they are talking about. Also I am by a MTF and not ONE person pregnant person I know sees a military doctor for their prenatal care and non of them will deliver at an MTF (it is also not IP). I would call again and get a better person
    Unless things have changed in the last seven years, you are automatically enrolled in Prime, not Standard. Also, I live about 35 miles from the hospital I'm expected to deliver at. I'm at least 60-70 miles from the hospital (Bethesda) they'd send me to if I started to have issues. My understanding was that I would be referred out because of the distance. The MTF OB doesn't even show up on the Tricare website. However, it doesn't matter. No matter what, I will not be referred out. It is the policy in this area. The only way to be seen by a civilian here is to have Standard. It takes so long to get to these hospitals because the traffic here is insane seven days a week. I am going to have a chat with my OB tomorrow, but I know she won't refer me out, so I'm switching to Standard as soon as DH comes home from a short TAD trip.

    Things must have changed.  I was married in November 2010 and automatically enrolled in Standard, which is what I wanted anyhow.

    OP, all AD Military members are enrolled in Prime they do not have a choice.  That has nothing to do with what you were enrolled in.  If they gave you paperwork to fill out that paperwork was to switch you from Standard to Prime.  I was given that same paperwork and started to fill it out.  We then asked the guy at the Tricare office a couple of questions.   He explained that I was already in Standard (which as I said above was what I wanted) so we shredded the paperwork. 

  • I was married in 2004, so 7 years ago and I was automatically enrolled in Standard.  I had to fill out the paperwork to be on Prime.  From my understanding it has been like that for a long time.

  • imageSheilaE:

    I was married in 2004, so 7 years ago and I was automatically enrolled in Standard.  I had to fill out the paperwork to be on Prime.  From my understanding it has been like that for a long time.

    This has been my experience as well. My H enlisted in 2009 (we were already married) and I was automatically enrolled in Standard. I stayed on Standard until we PCS'd here.

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  • imageLissa832:
    imageufsandra85:
    when entered in deers you are automatically enrolled in standard and you phyisically have to change yourself to prime. tricare is retroactive to the day you are married so if you want to go to the doctor you can pay and submit your bills although I dont encourage this it is possible. Also it is a tricare rule that if you are more than 30 ish (cant remember the exact number) miles from an MTF they will assign you a non military pcm. I would call again and talk to someone who actually knows what they are talking about. Also I am by a MTF and not ONE person pregnant person I know sees a military doctor for their prenatal care and non of them will deliver at an MTF (it is also not IP). I would call again and get a better person
    Unless things have changed in the last seven years, you are automatically enrolled in Prime, not Standard. Also, I live about 35 miles from the hospital I'm expected to deliver at. I'm at least 60-70 miles from the hospital (Bethesda) they'd send me to if I started to have issues. My understanding was that I would be referred out because of the distance. The MTF OB doesn't even show up on the Tricare website. However, it doesn't matter. No matter what, I will not be referred out. It is the policy in this area. The only way to be seen by a civilian here is to have Standard. It takes so long to get to these hospitals because the traffic here is insane seven days a week. I am going to have a chat with my OB tomorrow, but I know she won't refer me out, so I'm switching to Standard as soon as DH comes home from a short TAD trip.
    Of you would rather go some place closer I would call because I know this is a rule at least for the south region. When I was in charleston they closed the navy hospital and moved it to base and they automatically switched my pcm because I was out side the acceptable mile radius for a pcm.

    Married 11/27/09 and TTC right away
    Dx: Complete septate uterus with cervical duplication, endometrial polyps, PCOS, endometriosis, hypo thyroid, luteal phase defect
    4 uterus surgeries to correct my complete septum and to remove polyps and 2 years of seeing the RE, medicated cycles and IUIs
    Baby 1 and 2: BFP 3/3/11 with 2 babies EDD 11/1/11, M/C 4/6/11
    Baby #3: 8/11 pregnant EDD 4/27/11 and m/c:(
    Baby #4: 10/12/11 BFP! EDD 6/16/12m/c 10/26/11
    Baby #5: 3/13/12 BFP! EDD 11/25/12 ANOTHER m/c :(

    Baby #6: 2/14/13- BFP! EDD 10/24/13, CP 2/19/13
    Baby #7: 3/15/13- BFP! EDD 11/27/13, another CP
    Baby #8.  BFP 5/19/13 EDD 1/22/14. 8 was not our lucky number

    4th septum resection on 5/31/13.
    Baby #9: 6/29/13 BFP. C section scheduled for March 5th!

    My miracle baby was born March 5 at 9:33am. He was 8 lbs 12.5 oz and 21.25 inches long!

    image"">

  • Actually when you are enrolled into deers you are auto. enrolled into STANDARD.  You then have to go to the tricare office to enroll into PRIME if you so wish.  If you enroll by on or before the 20th of the month then your Prime effective date is the 1st of the following month. Example.  If you enrolled March 15th 2011 then its effective for April 1st 2011.   If you enroll after the 20th then the effective date is the month after the next month. Example you enrolled today March 31st, your effective date will not be till May 1st 2011.

    Also if you are more than 50miles from a MTF then you are allowed to be seen my a civ. provider.


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  • We just moved from there. I know lots of people who delivered at Johns Hopkins with Tricare. I didn't but I know people did.

    Switching can be a pain sometimes. I hope it gets sorted out soon. 

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  • imageLissa832:
    imageufsandra85:
    when entered in deers you are automatically enrolled in standard and you phyisically have to change yourself to prime. tricare is retroactive to the day you are married so if you want to go to the doctor you can pay and submit your bills although I dont encourage this it is possible. Also it is a tricare rule that if you are more than 30 ish (cant remember the exact number) miles from an MTF they will assign you a non military pcm. I would call again and talk to someone who actually knows what they are talking about. Also I am by a MTF and not ONE person pregnant person I know sees a military doctor for their prenatal care and non of them will deliver at an MTF (it is also not IP). I would call again and get a better person
    Unless things have changed in the last seven years, you are automatically enrolled in Prime, not Standard. Also, I live about 35 miles from the hospital I'm expected to deliver at. I'm at least 60-70 miles from the hospital (Bethesda) they'd send me to if I started to have issues. My understanding was that I would be referred out because of the distance. The MTF OB doesn't even show up on the Tricare website. However, it doesn't matter. No matter what, I will not be referred out. It is the policy in this area. The only way to be seen by a civilian here is to have Standard. It takes so long to get to these hospitals because the traffic here is insane seven days a week. I am going to have a chat with my OB tomorrow, but I know she won't refer me out, so I'm switching to Standard as soon as DH comes home from a short TAD trip.

    Someone lied to you.  What you do is go online to the tricare site.  Find PCM's/OB in your area call them up to see if they're taking new patients.  If yes turn around and call tricare for your region.  Tell them you are X miles,Y minutes from a MTF and that Dr.Jones at ABC Clinic is taking new patients and you'd like to switch your PCM to them.  Easy as pie. I've yet(knock on wood) to have any issue picking my doctor while on prime.

    Now I do know in some areas to see a specialist you have to travel outside of that radius.  If this happens they can/will reimburse for that.  This however, isn't in regards to PCM,OB/GYN, Pediatrician,or hospital.

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  • imageLissa832:
    imageufsandra85:
    when entered in deers you are automatically enrolled in standard and you phyisically have to change yourself to prime. tricare is retroactive to the day you are married so if you want to go to the doctor you can pay and submit your bills although I dont encourage this it is possible. Also it is a tricare rule that if you are more than 30 ish (cant remember the exact number) miles from an MTF they will assign you a non military pcm. I would call again and talk to someone who actually knows what they are talking about. Also I am by a MTF and not ONE person pregnant person I know sees a military doctor for their prenatal care and non of them will deliver at an MTF (it is also not IP). I would call again and get a better person
    Unless things have changed in the last seven years, you are automatically enrolled in Prime, not Standard. Also, I live about 35 miles from the hospital I'm expected to deliver at. I'm at least 60-70 miles from the hospital (Bethesda) they'd send me to if I started to have issues. My understanding was that I would be referred out because of the distance. The MTF OB doesn't even show up on the Tricare website. However, it doesn't matter. No matter what, I will not be referred out. It is the policy in this area. The only way to be seen by a civilian here is to have Standard. It takes so long to get to these hospitals because the traffic here is insane seven days a week. I am going to have a chat with my OB tomorrow, but I know she won't refer me out, so I'm switching to Standard as soon as DH comes home from a short TAD trip.

    When I was in Quantico (not even a year ago) most of the families see a PCM out in town.  I was on Prime while there and my doctor was a civilian.  I did not have to be on Standard.  I knew pregnant women that were on Prime in Quantico too, and they had their babies in Stafford or Woodbridge. 

  • Call the Tricare North region.  All of us giving you conflicting and vague information is going to just confuse you more.  Call them up, tell them your entire situation, and they will sort it out for you.  I have found the Tricare reps to be extremely friendly, helpful, and informative.

    If that doesn't work, go on their website and find the closest Tricare Service Center.  Then go and see someone face to face to help you get it sorted.

    Fwiw, I had two babies while stationed at a remote base in Maryland.  Both were delivered by civilian doctors at civilian hospitals.  Military insurance does not always equal military doctor.  They don't expect you to drive 2 hours for an appointment when you can be seen closer to home.  Don't worry. 

    Also, Tricare Standard covers OB care 100%.  There are no co-pays.  So if you would prefer Standard or the OB you want to see only takes Standard - go for it.  Johns Hopkins takes Tricare Prime.

  • I just skimmed the previous responses so I may repeat what was already said.

    First, I would go to your nearest Tricare office and actually talk to a person.  I can get five different answers by talking to five different Tricare reps over the phone, but in person I can get the real info I need, as well as any paper work.  They may be able to tell you when you'll be active as Tricare (usually the 1st of the month).

    Second, I live ten minutes from Bethesda yet am working on getting a referral out to a civilian OB because I didn't like the care there while pregnant with DS.  Add to that your distance from it, and I'd definitely try to get out of the military OB system.  Once you're in Tricare and have been assigned a PCM (primary care manager), you can meet with them to plead your case.  Mine was very willing to do it for me; other doctors may not be.  It helps if you have a specific civilian practice and/or hospital in mind and give reasons why you want to use them.  While distance is a valid concern, you may need more if you fall within the radius of Fort Meade (which, as of 1.5 years ago, had OB appointments but didn't handle deliveries).  For example, my request includes how my own approach is more in line with the midwifery practice I want to see, the hospital they deliver at has labor tubs, etc.  If your referral is denied, you can appeal it.

    Good luck!

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  • Okay first of all hopefully you are enrolled in DEERS because you need to be enrolled into that before Tricare.  Anyways I currently live in Ohio and I have Tricare Prime North and I live over 3 hours away from the airforce base and Tricare allows me to go to a clivilan OB and hospital.  They have to allow you to go off post if you live more than a certain amount of miles from a post.  Now I would call again and speak with someone at Tricare or ask where the nearest Tricare office is at so you can speak to someone in person.

  • I'm from Baltimore too!  I had my baby on Standard at GBMC.  It was great!!

    You can also stay on Prime and go to Hopkins.  Tricare keeps sending me postcards to tell me I'm eligible for that, but I like Standard, so I haven't switched.  I would not feel comfortable going to Bethesda.  It is just too far even without traffic. 

    Also, are you calling the Tricare North number (I think it's north), or are you calling base or something?  I've always been able to speak to someone after only a few minutes on hold. 

  • when you enroll in tricare prime...there are time frames...you have coverage under standard until prime enrollment take effect...usually if you enroll at the end of the month, prime will take affect the 15th of the next....
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  • I hope you are still checking for replies... But my husband was stationed in Annapolis and if I stayed with tricare I would have also had to go to Bethesda to deliver.  I switched to US Family Health Plan, which is only an option in certain areas with smaller bases.  www.usfhp.com will give you information and tell you how to enroll.  I saw civilian doctors, delivered at a civilian hospital, and my daughter went to a civilian pediatrician.  We have since left the area and now I have to go to a base and I have seriously considered driving the 3 hours so I could go to my old doctors again.  It was an amazing option to have, and I don't think a lot of people know about it.  You may want to check it out.
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