Military moms, help me!

[mesa]

I've read some old threads about the relative success of getting Tricare to cover home births for dependents. My situation is a little different, though. I'm in Korea, more than 40 miles from the nearest MTF. The status quo up here is that moms go to Seoul at 37-38 weeks and live in a modified hospital room until delivery. Or, of course, we can go to a local Korean hospital and deliver. Besides the fact that I want a home birth, I have 3 other children, 2 of whom are school aged. I'm not exactly sure how the Army expects families to just drop everything for 2 or more weeks and live in another city. And, well, I simply do not want to deliver in a hospital that I have heard terrifying things about, and with a language barrier to boot.

So, there is an OBGYN here, who offers homebirth services, as well as a CNM. They are both Korean, but they speak excellent English and they are willing to attend my birth. What do you think my chances are of getting Tricare to cover my birth?

We're on Tricare Prime Overseas.

[mntnmom]

Your chances are pretty good. If you can get a referral offpost you can probably stay on Prime. We're in Germany, and I had to switch to Standard to get them to pay for mine because they weren't giving offpost referrals. There is a doula/ Army wife working in Korea who posts over in Birth professionals. I bet if you PM her she can give you some good advice.

[Amynf1]

I'm in Donducheon as well. I am also pregnant with #2 and a birth doula. I have attended clients both at St. Mary's in uijeongbu (which wasn't bad but I imagine would be without someone who knows the ropes to help out) and also at 121. The Stork's Nest is good in theory but really works best for those without older kids.

As for as Dr. C, I am using him for a HB. Tricare has been covering 80% of his fee which is 5 million won. He's attended four HB's on post in the housing area at Yongsan so far That includes labor and delivery but not the office visits and labs etc. Of course, you can do all that stuff at the TMC for free and then transfer care to Dr. C later. I'd just go ahead and line him up now because he is busy. He will attend a HB in Dongducheon though. I am not going that route because I am HBACing and St. Mary's is too far away in the event of transfer in my opinion. So I will be going into Seoul at 39 weeks and will be birthing at a friends house about 10 mintues away from SoonChoonHyang, the natural birth hospital in Hannam. I am also working with Dr. C to get him on the Tricare approved provider list so that we can get 100% reimbursement.

Also, a referral shouldn't be a problem. I got easily one but I was released from 121's care for other reasons. Tricare said they can't tell us were to birth or what doc to use. That said, when I saw him last week he said he had another military mom who was having some problems with Tricare approval but I don't know what her situation is.

If you did want to go the cheaper route, you could always use midwife Rosa. Her English is decent. She's the one that works with Dr. C. She'd be the equivalent of a CPM in the States. They also do breech vaginal as a team.

If there is anything I can help you with, please let me know.

[MommaKitten21]

I have no advice, but want to say good luck!! I am just about to start my fight with tricare to cover our home birth!! (But I'm in the states)

[mesa]

Originally Posted by mntnmom

Your chances are pretty good. If you can get a referral offpost you can probably stay on Prime. We're in Germany, and I had to switch to Standard to get them to pay for mine because they weren't giving offpost referrals. There is a doula/ Army wife working in Korea who posts over in Birth professionals. I bet if you PM her she can give you some good advice.

Thank you!

Originally Posted by Amynf1

I'm in Donducheon as well. I am also pregnant with #2 and a birth doula. I have attended clients both at St. Mary's in uijeongbu (which wasn't bad but I imagine would be without someone who knows the ropes to help out) and also at 121. The Stork's Nest is good in theory but really works best for those without older kids.

As for as Dr. C, I am using him for a HB. Tricare has been covering 80% of his fee which is 5 million won. He's attended four HB's on post in the housing area at Yongsan so far That includes labor and delivery but not the office visits and labs etc. Of course, you can do all that stuff at the TMC for free and then transfer care to Dr. C later. I'd just go ahead and line him up now because he is busy. He will attend a HB in Dongducheon though. I am not going that route because I am HBACing and St. Mary's is too far away in the event of transfer in my opinion. So I will be going into Seoul at 39 weeks and will be birthing at a friends house about 10 mintues away from SoonChoonHyang, the natural birth hospital in Hannam. I am also working with Dr. C to get him on the Tricare approved provider list so that we can get 100% reimbursement.

Also, a referral shouldn't be a problem. I got easily one but I was released from 121's care for other reasons. Tricare said they can't tell us were to birth or what doc to use. That said, when I saw him last week he said he had another military mom who was having some problems with Tricare approval but I don't know what her situation is.

If you did want to go the cheaper route, you could always use midwife Rosa. Her English is decent. She's the one that works with Dr. C. She'd be the equivalent of a CPM in the States. They also do breech vaginal as a team.

If there is anything I can help you with, please let me know.

Amy, I can't thank you enough for responding here. Did you have to switch to Standard (is that even possible here? I have no idea) to be able to use him? At what point should you plan to transfer to him? And does he take over prenatal care at that point?

I'm so excited

[Amynf1]

Originally Posted by mesa

Thank you!


Amy, I can't thank you enough for responding here. Did you have to switch to Standard (is that even possible here? I have no idea) to be able to use him? At what point should you plan to transfer to him? And does he take over prenatal care at that point?

I'm so excited

I did not have to switch to Standard to use him. I don't know if that's because I was released from 121's care or if that is how it works for everyone who uses him. The other women who have used him have all been command sponsored (they all live on post which i is how i know this) and Tricare covered 80%. We were told that if he was an authorized provider that Prime would pay 100%.

I transfered care immediately after I confirmed pregnancy at the TMC and got released from 121. I saw him for the first time at 6 weeks. Frankly, I hate the TMC and would rather take the 3 hour round trip train ride once a month to see him than to go there but I guess it's a matter of preference and what's convenient for you.

If I were you, I would go ahead and make an appointment with him and make sure you like him (you will he's amazing!!) and just talk to him about what you want to do. If you want to keep going to the TMC for all your prenatal care and transfer later, he'd be ok with that too. He knows it's free if you go to the TMC. Tricare is paying 100% for all my visits to see him for prenatals but I have to pay up from and request a reimbursement. I'm ok with doing that so it just depends on your situation. You could also do partial care at the TMC and the rest with him. You could go to the TMC to do labs or anything that costs a lot but then go to him for your monthly prenatal and just take him a copy of the results.

He is extremely flexible. His goal throughout pregnancy and birth is to support your preferences. He is there only as a guide or as back up if you need help and that goes for all aspects of his care. He is very much on the midwifery model of care to the point that the last few prenatals are done in your home, even if you live as far out as we do.

I am not sure if you know this but he is a certified Hypnobirthing practitioner. He is a big believer in undisturbed labor and breathing the baby out rather than pushing to reduce tearing. It's worth it to me to go to him each month and deal with the train ride and the reimbursement because he spends about an hour with me each time talking and getting to know me and what I want. Worth every second and penny if you ask me

Let me know if I can help you at all. Good luck!

[mesa]

what does he charge for each visit, and how long does it take for you to receive reimbursement?

I'm not feeling the TMC, either. If I can avoid having prenatals there, it would be fantastic. How do you get released from 121? Thank you for your help

[Amynf1]

The charge for each visit depends on what's being done. It if it's just the visit and nothing else (no labs, no u/s etc) it's 30,000 won. At 12 weeks I had blood work and an u/s and plus the charge for the pap from the 6 week visit and that was more like 400,000 won. He will offer an u/s at every visit because that's what Korean's expect but I told him last time i was only having the 22 week one and that was it so that's a charge I won't have every month. I don't know how much that u/s will cost. It's the big anatomy scan so I expect it will be more than the 150,000 won one I had at 12 weeks (I wanted to know if my placenta was anterior b/c of my c/s scar). Of course, you can opt out of that or do it at 121. I THINK area I moms can do the 20 week u/s at 121 but if there refer you to the clinic over by 2nd market you may as well just do it at Dr. C's.

Reimbursements take 60 days. I sent my big charge in already but for the smaller ones I am just going to let them pile up for a while and send them all at once.

I was released by 121 because I intend to VBAC and I have an inverted t incision scar. 121 will only VBAC if it is the standard bikini cut. So they risked me out and released me but I went there specifically to ask for that. Dr. Wilson (which is the doc I would recommend asking for if you have to go to 121 at any point, but she's due in Feb and will be on maternity leave for a while after that) had no problem with it. She actually supports what I am doing but the hospital policy doesn't due to lack of staffing and even though they say they support VBAC they really aren't very VBAC friendly overall. Even if the hospital would support me I wouldn't do it there anyway. I had my son there, it was a good experience even though it ended in c/s (52 hour natural labor, face first presentation, fetal distress) and I have attended some great births there with clients but they are too strict on VBACs in my opinion.

Dr. C also recommend an organic prenatal and organic fish oil. I got them but they are expensive. I think for the two it was 200,000 won and it's enough to last maybe 4 months??. They coded them as prenatals and not supplements so hopefully Tricare will cover them, I'll let you know once I get it back in the mail. He offers them at 12 weeks so you have some time to think about that, I just wanted to prepare you for the cost because they didn't say anything to me and I didn't ask until I saw the bill and was handing them my card. I looked up the vitamin, it is one of the best on the market, but it is imported from the US so it has a higher cost here.

And you're welcome! Any time

[Amynf1]

I just wanted to let you know that we just got our first reimbursement back from Tricare. It was for my 6 week, 12 week and 16 week visits. It included two u/s and the 200,000 won for the organic prenatals, a pap, labwork and office fee. The total was $800 and we got 100% back It only took about three weeks from the day we sent it until the day we got the check back too!

[gentlestrengths]

From what I've heard - from other homebirthers - Tricare will cover homebirth with any sort of midwife/licensed attendant when you are overseas. Contact them and find out - make them research it, tell them you know people that have had it covered 100% when they are overseas.

When I was in Hawaii they paid my midwife most of what I owed her. I have no idea why, but they did. She filed, and they paid. We were getting mixed information, so she just filed for us.

[Plummeting]

Originally Posted by gentlestrengths

When I was in Hawaii they paid my midwife most of what I owed her. I have no idea why, but they did. She filed, and they paid. We were getting mixed information, so she just filed for us.

If she was a CNM, they paid because CNM's are covered. If she was a CPM, they paid because someone didn't notice she was a CPM. It happens sometimes.

[lovebug]

i JUST got off the phone with Tricare about this

they said they cover CNM, but ONLY CNM. if she is not under tricare all you have to do is submit the paper work and pay upfront. if she takes tricare then all you need to do is get a ref to her and they will pay for it. if she is not under TC then you may have to pay some out of pocket.

GOOD LUCK!

i would call tricare and talk to them!

[Amynf1]

Originally Posted by lovebug

i JUST got off the phone with Tricare about this

they said they cover CNM, but ONLY CNM. if she is not under tricare all you have to do is submit the paper work and pay upfront. if she takes tricare then all you need to do is get a ref to her and they will pay for it. if she is not under TC then you may have to pay some out of pocket.

GOOD LUCK!

i would call tricare and talk to them!

Thanks for the info. We are talking about a HB OB here in Korea. Tricare pays 100% of his prenatal care and 80% of his HB fee. He is filing paperwork to get 100% reimbursement for the HB fee. Hopefully it goes through before I birth in July, but i am not really worried about it either way.

[Tenk]

Even on Prime, if your 40 miles or more away you can see another Dr.

I live 42 miles from our MTF, and was sent out (I begged because our last daughter passed away while I was delivering in a MTF) and I didn't have to get a referral or anything. I think all you need to do is call Tri-care (east, west or what ever yours is called and explain the situation, and ask what the process is to get it done.

It's a lot of phone calls but you can do it mama!!!

[lovebug]

Originally Posted by Amynf1

Thanks for the info. We are talking about a HB OB here in Korea. Tricare pays 100% of his prenatal care and 80% of his HB fee. He is filing paperwork to get 100% reimbursement for the HB fee. Hopefully it goes through before I birth in July, but i am not really worried about it either way.

yes an OB is another store i said ONLY CNM because they will not cover any other type of MW....

[bsideu4ever]

I had a homebirth in Hawaii, and could not get Tricare to cover any of it. So we paid out of pocket. There was NO way I was going to give birth at the MTF...it was horrible!!!