I switched to Standard after a horrible experience last year at our MTF. I have had one ob visit, and I just got a bill for over $100. I was thinking pg was 100% covered, even on Standard?? Am I wrong? If I owe it, I will gladly pay it (seeing a civilian was worth it to me with my history of loss) but I was thinking I wouldn't have to?
Re: Tricare Standard and pregnancy?
The only ultrasound Tricare will cover unless the doctor billed it as "medically necessary" is the standard ultrasound around 20 weeks. An Ultrasound to confirm pregnancy is not considered medically necessary since it can be done with a blood test, however that 100 dollars I would check on unless they were confirming your pregnancy at the time of the appointment. You should call your tricare region line to make sure they got your global authorization so that you will be 100% covered or the dr will try to charge you for you deductible and 20% cost share.
I am on standard so i could see a midwife off mtf and i called 4 times to make sure i had my global authorization because they were originally trying to charge the 20% cost share for my total prenatal care, 1700$. This was wrong for me on two accounts, 1, i already had my pregnancy confirmed while on prime at an mtf, and 2, I was 21 weeks when i saw the midwife and already had global auth, i just needed to make sure it transferred when i switched regions. now i pay nothing until admitted to the hospital for delivery, then its 17ish dollars per day.
As Lissa mentioned, though, if you have to see a doctor for anything not pregnancy related, you will get billed. But, it shouldn't be too much.
You should call the billing department and make sure things were coded correctly and then call Tricare claims and make sure that it's something that wasn't covered.
I went to the ER at 9 wks for spotting, and the ER coded it as something not pregnancy related at all {even though it was} and I recieved a bill for 300 bucks. After a few phone calls I paid nothing.
I've also had 3 u/s so far this pregnancy, including a "dating" u/s at my first appointment, and haven't paid for any of them.
Pregnancy Week by Week stuff.