November 2015 Moms

Tricare Mommies & Maternit21

Ok ladies, I did a search and didn't find anything in our group on this.  I had Maternit21 done last month.  However, I got a letter this weekend from Sequnom saying that Tricare
doesn't cover this test.  But I haven't gotten a bill from Tricare, my highrisk dr. or the lab.  Has anyone else had this problem?

BabyFetus Ticker

Re: Tricare Mommies & Maternit21

  • Sometimes billing can be delayed, especially if there was a back & forth with your insurance and the lab and they just determined the test is not covered. When did you get the letter saying that your insurance (assuming that's what Tricare is) doesn't cover? If you just got the letter, you'll get the bill soon. If you think your insurance should have covered it, then give them a call.
  • Loading the player...
  • Just an FYI....my tests were not covered 100%...I received a bill for $500 and a bill for $750 from the Maternit21 lab. I called them and asked about the bills and since the test was considered "out of network" they were not fully covered. I am considered advanced maternal age at 36. Without even asking they reduced my bills:

    $750 went down to $140
    $500 went down to $25


    Moral of the story is as soon as you receive a bill from them, call them directly. They even send a note asking to call them and not your insurance company.

  • kmd91kmd91 member
    I second giving Maternit21 a call. I personally haven't experienced this, actually it was a big fear of mine which caused me to choose to go to an army facility over civilian because I'm a worrier about things not being approved by insurance. I do hear that the folks at Maternit21, or whatever the parent company may be, are pretty willing to help as far as the testing not being covered by insurance so that you don't end up footing a ridiculous bill.
  • Thanks Ladies.  :)  I will be on the lookout for the bill.

    BabyFetus Ticker
  • KeHill08KeHill08 member
    edited June 2015
    I haven't had an experience with Maternit21, but in December I had a miscarriage and I was visiting home and couldn't go to a military hospital. Aurora tried sending me a bill for the remainder of what Tricare wasn't covering so I called Tricare and the rep basically told me that Aurora wasn't allowed to bill me like that because of some agreement that essentially states that Tricare will pay so much and the remainder of the bill is a tax write off for the facility. The rep sent a prewritten letter to Aurora and I never heard anything more about the bill. If and when you get the bill I would call Tricare about it. I'm also wondering... do you have standard or prime? If you have prime did your PCM or OB write a referral?
  • Sometimes billing can be delayed, especially if there was a back & forth with your insurance and the lab and they just determined the test is not covered. When did you get the letter saying that your insurance (assuming that's what Tricare is) doesn't cover? If you just got the letter, you'll get the bill soon. If you think your insurance should have covered it, then give them a call.

    This and definitely call them.

    Also, in some cases you won't receive a bill until you deliver. Any of my copays, excluding the deductible that are related to pregnancy I won't recieve until I deliver.
  • Also, if your doctor recommended it due to risk factors, it could be as simple as having a prescription sent to Tricare as well. (Assuming it's in network).
  • @Kehill08 I'm Prime.  The OB put in for the referral.  Due to my age..

    BabyFetus Ticker
  • Ok, well I'm definitely no expert, but going off of what I was told (by a Tricare rep), if a referral was put in for you, Tricare should cover it
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