Does Tricare cover delivery at any hospital? — The Bump
Military Families

Does Tricare cover delivery at any hospital?

Here's the situation...

My husband is deployed and I'm in my home state (I was actually never able to move out by him because he deployed very shortly after we got married and I'm under a contract here). 

When I first conceived and was going to the doctor, we were not married yet, so I did everything under my insurance (which I luckily have amazing insurance). However, the doctor my insurance covers is not one Tricare would cover. I would like to give birth at the hospital my doctor is at. Obviously I can and will bill my health insurance for the delivery but I was wondering if Tricare will also cover the delivery at this hospital (so I can bill them for whatever my insurance might not cover). I'm assuming they would because it is an emergency and it's not like I'm near a military hospital anyway. 

 Thoughts? 

Re: Does Tricare cover delivery at any hospital?

  • i think if you are not within 50 miles of a military facility you can go to any hospital to have your baby...however i would give tricare a call and confirm this with them..they would have more information for you.....when i lived in jersey i could go to any dr. as long as tricare was accepted since the closest facility was over 50 miles....make sure you have tricare prime and not standard though....
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  • Why Tricare prime and not standard? Just completely curious as I'm new to this. 
  • Tricare standard would be a whole lot better in this situation than Prime,IMO.
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  • Make sure your current address is accurate in Tricare then call them and ask.  If you have other health insurance I think Tricare will be secondary but they can tell you for sure.
  • If you are not within 30 miles of a MTF you will be on Tricare Remote and can use any civilian doctor that takes Tricare. If your doctor takes Tricare then you can deliver at whatever hospital he/she delivers at, as far as I know. You can also switch to Standard and use any civilian doctor that is in network and it will be covered 100 for anything medically necissary during pregnancy and delivery with the exception of a small daily fee while you are in the hospital. I switched to Standard, found a practice that took tricard and delivered at the hospital I wanted to deliver at. I had an epi and eventually an unscheduled c section and only paid about 50 out of pocket for the few days I was in the hospital during recovery.

    Also, if the doctor is out of network and you are on Remote or Standard then Tricare will still cover a percentage i believe, but I have no idea what since I have never been in that situation. I would call Tricare and ask, they have always been very helpful when I have called with any questions.
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  • You do have to be careful if you're using another form of insurance with Tricare. If you use both to cover the costs then you might receive a bill from Tricare.
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  • image LyndseylovesHugh:
    Also, if the doctor is out of network and you are on Remote or Standard then Tricare will still cover a percentage i believe, but I have no idea what since I have never been in that situation. I would call Tricare and ask, they have always been very helpful when I have called with any questions.
    They still cover 100%. I delivered under Standard with an out of network provider and hospital. All was covered save the daily fee. 
  • image Green492-2:
    Why Tricare prime and not standard? Just completely curious as I'm new to this. 

    the only reason i say prime is b/c from experience when i was put on dh's tricare they put me on standard remote and everytime i would go see the ob and other dr. about a week or so later we would receive a bill in the mail from the visit and also for any type of bloodwork that i had to have done...I would still reccomend that you call tricare and ask them what you should do about it.

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  • image hbenevides:

    image Green492-2:
    Why Tricare prime and not standard? Just completely curious as I'm new to this. 

    the only reason i say prime is b/c from experience when i was put on dh's tricare they put me on standard remote and everytime i would go see the ob and other dr. about a week or so later we would receive a bill in the mail from the visit and also for any type of bloodwork that i had to have done...I would still reccomend that you call tricare and ask them what you should do about it.

    I've never heard of standard remote. Prime remote yet. Also it could just be an issue with how your OB office was coding their bill.

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    CJ 05/29/2013

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