TriCare Prime Birthing Center Referral Denied?

ardecarli · July 2013

Hi, we are stationed at Fort Meade and I am looking to give birth at a birthing center in Annapolis. I was told that Fort Meade would deny my request. Has anyone been through anything like this. Fort Meade does not have birthing centers or the facilities that the birthing center has. I am looking for advice from any military moms who have given birth at a birthing center with TriCare. Thank You!!!

ufsandra85 · July 2013

in the last several months with the budget cuts MTFs have been ordered to not let active duty prime patients see outside providers if they can take care of the patient. So if they have room to see you you are out of luck most likely. You can always switch to standard

ardecarli · July 2013

Thanks I appreciate the feedback. I am trying to push back a little because they don't offer the facilities or options that I am interested in and it is cheaper than the hospital birth. We shall see.

KandT0919 · July 2013

So if you're on Prime at Fort Meade, you go to Walter Reed to deliver??

Oasismomma · July 2013

I gave birth to DS using Special Beginnings (the birth center I'm assuming you're referring to). Tricare approved it. Talk to the front desk at SB. Because of their proximity to Annapolis, they have a lot of military patients and know how to navigate the system. Good luck!

Oasismomma · July 2013

Just read the other responses and wanted to add, maternity care is covered 100% under Standard. If your only option to be seen at SB is to switch to Standard, you won't pay anything.

ardecarli · July 2013

KandT0919:
So if you're on Prime at Fort Meade, you go to Walter Reed to deliver??

Yes. That is what I was told.

ardecarli · July 2013

Oasismomma:
I gave birth to DS using Special Beginnings (the birth center I'm assuming you're referring to). Tricare approved it. Talk to the front desk at SB. Because of their proximity to Annapolis, they have a lot of military patients and know how to navigate the system. Good luck!

Oh wow really? I did speak with the insurance lady and she said that only a handful of people have been able to get referrals. Special Beginnings is an in network provider so Tri-Care has no issues with them it is just Fort Meade. I switched my PCM and have had no other problems.

keg79380 · July 2013

You can switch to Standard and all prenatal /maternal appointments, test, etc will be covered. I switched and will be giving birth in a hospital and was told the only thing I'd have to pay is my hospital stay which the hospital said was 17 per day. You can switch back to Prime at any time and do these switches up to three times a year. Baby can be placed on Prime or Standard regardless of what you have as well.

imakeeff0rts · July 2013

ufsandra85:
in the last several months with the budget cuts MTFs have been ordered to not let active duty prime patients see outside providers if they can take care of the patient. So if they have room to see you you are out of luck most likely. You can always switch to standard

^All of this. Sorry, but you'll have to switch if you want to choose your provider =

ardecarli · July 2013

You guys were right. I switched to US family Health Plan (aka Johns Hopkins) and I am loving it. Everything is working out great and I have two referrals one to my OBGYN and one to the birthing center, so I can decide what way I want to go. Same as Prime, no co-pays. Thank you.

KIR2DS4 · July 2013

hercules03 said:

If you are an E-5 or above (or your spouse is), you are locked out of Prime for 12 months. Take this into consideration when considering other medical issues, including birth control after the fact.

I'm on Standard. My birth control is free via Express Scripts, just FYI in case someone sees this and gets concerned.

mom2curlygirls · August 2013

I chose to switch to Standard with my second daughter along with this one too. I was locked out for a full year but I did not find that to be a problem. The peace of mind I had getting to choose my Dr and facilities was worth any of the hassle or fees. I did not pay a single dime with my second and thus far haven't paid anything with the third. It turns out that I made a very good decision because I've had a lot more issues with this pregnancy than with any of my others. I feel like I can be my own advocate and my quality of care is in my hands not a protocol book written by the military to save as much money as possible. Just my opinion.

Rachelkay06 · September 2013

ardecarli said:

You guys were right. I switched to US family Health Plan (aka Johns Hopkins) and I am loving it. Everything is working out great and I have two referrals one to my OBGYN and one to the birthing center, so I can decide what way I want to go. Same as Prime, no co-pays. Thank you.

Did you have to switch to Standard to to go Johns Hopkins to get your referral? I'm Active Duty and hoping to go to Special Beginings as well. They also told me it is hard to get a referral, I'm going for the OB Orientation at Bethesda tomorrow, so I'm going to see what they say, but I would like to be prepared to explore other options. I really want a natural water birth.

Gismo123 · September 2013

hercules03 said:
If you are an E-5 or above (or your spouse is), you are locked out of Prime for 12 months. Take this into consideration when considering other medical issues, including birth control after the fact.

This. Not pregnancy related but my dh is an e-6 and we just switched our son to standard because prime just wasn't cutting it for the pedi's they allowed us to see. We are locked out for a year to switch him back, not that I ever will, but just like pp it is good to know all information before making the jump.

ardecarli · September 2013

Rachelkay06 we switched to Johns Hopkins Plan and I LOVE IT!!!! It is so great. I have had no problems. Will pay $0 to birth at Special Beginnings. Hey, if you are local we should get together sometime!

TriCare Prime Birthing Center Referral Denied?

Re: TriCare Prime Birthing Center Referral Denied?

Choose Another Board

Search Boards