Military Families
katiep337
member
Birth center and Tricare?
katiep337
member
Does anyone know if birth centers fall under the universal maternity coverage on Tricare Standard? I called Tricare, and they couldn't find my birth center by name, but it could be because it is inside of a hospital. They said I could have the birth center send a pre-authorization to Tricare, but I thought I'd see if any of you have given birth in a birth center with Tricare. What were your costs? Thanks!!
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Re: Birth center and Tricare?
I was scheduled to give birth in a birthing center in a hospital and it was covered under Tricare Standard. I labored in the birthing center but I ended up having a c-section, so not sure what the cost would have been if I actually gave birth in the birthing center, I am guessing less than the bill I got since I would assume a c-section is more than a vaginal birth, but I do not know. I actually just got my bill today, my portion was $51.14 for the birth and $14 for the drugs I took during recovery (that bill was from the pharmacy in the hospital, not the birthing center).
Edited for clarity
I hate to say yes as it probably depends on how the birth center does it's billing but when I had my second it was 100% covered. The only fee I paid was the daily registration fee or whatever they call it. Something like $25 is what I was charged.
It might be helpful if you say which birth center or hospital in case it was one we have direct experience with.
We're using a free standing birth center and it's going to cost us $1,000 out of pocket. The cost is for the facility fees because New Mexico doesn't do state licensure for free standing birth centers so Tricare won't cover it. They are, however, paying for the professional fees, ultrasounds, lab work, etc. The birth center gave us 50% off the facility fees since we're military.
EDIT: I'm Prime so I have no idea how it would be if I were Standard. Your best bet is to have the birth center and/or your midwife's billing people call Tricare.
generally the ones in the hospitals are covered under standard, but you can call the center yourself and get their claims number(I think that's what it's called, i did this like a year and a half ago) just to make sure.
I'm currently pregnant, and in San Diego, I'm going to UCSD hillcrest, they have a birthing center in the hospital, and it should be covered.