NT scan and Tricare Prime — The Bump
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NT scan and Tricare Prime

What scans and testing does Tricare cover? If I wanted to get an NT scan would that be covered? I heard for a healthy pregnancy they only cover 2 ultrasounds so I wasn't sure if this was an elective test.

Re: NT scan and Tricare Prime

  • Tricare covers as many ultrasounds as are medically necessary. If your doctor codes the bill correctly, the NT scan, as well as other necessary ultrasounds, will be covered. 

     Please read the FAQs at the top of the board. They are full of information about Tricare and pregnancy.  

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  • The NT scan is an elective test, but Tricare will cover it if performed in an MTF.  Unless there is a reason for more ultrasounds, Tricare usually covers two: one to confirm pregnancy/determine gestational age, and then an anatomy scan (where you MAY find out the sex, not guaranteed though, and will NOT be repeated by Tricare if baby does not cooperate).
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  • image MzCurnett8886:

    What scans and testing does Tricare cover? If I wanted to get an NT scan would that be covered? I heard for a healthy pregnancy they only cover 2 ultrasounds so I wasn't sure if this was an elective test.

    I was on Tri-care prime when pregnant with my son.  I was always seen at the base hospital. I asked about the NT scan and the obgyn I was seeing said sure they would put in a referral for it. It got approved and I went to a Civilian practice out in town for it. 

    Maybe I had a cool obgyn?  I don't know but it's a GOOD thing I got that scan because it was discovered I had a low papp A protein and I had to be monitored the rest of the pregnancy with extra u/s's and blood pressure tests.

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  • My advice is unless you have something in your family or SO's family is don't get the test. My OB only recommends it to those who have something in their family history, or are at risk for something like Down's syndrome. He also advised me, and after a lot of research I know its true, that the test itself comes back with a VERY HIGH percentage of false positives. I know pregnancy is scary, and you want to know if everything is ok, but if you do get a positive, and it is a false, then you will have also had to get a more invasive procedure AFTER the positive for nothing. I have nothing my my history, so I didn't get it with DD, nor did I get it with this pregnancy. TriCare IMO is no fun when it comes to ultrasounds, though lol.
  • as long as your doctor codes it correctly the NT scan is covered, even if your not high risk
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  • I'm Prime and not high risk and Tricare has covered 3 ultrasounds for me (a dating scan, NT scan, and anatomy scan) all performed by my OB off base. As long as its medically necessary, it will be covered. 
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