I know it's been covered...Tricare...

[mommy2jasmine]

I know there are countless threads on Tricare, and trust me, I've read through them, though, admittedly, not in their entirety. There's just too much to read.

So, long story short, I wanted a home birth, then found out it's a PITA to get one with Tricare, so I decided to just go to a birthing center. Birthing center can't handle VBACS, so I'm stuck with going to the hospital (not gonna happen, lol) or figuring out how to have a home birth, and get it paid for.

Here's what I have now. I've "googled" around, and found that there are CNMs in San Diego that will do home births. So, we're good there.

My question is, how much does Tricare cover? We really can't afford much, but I'm willing to do just about anything to make sure we have the money for this.

Thank you so much, and please excuse me if this has been asked. I really tried finding the answers, but even when I did find some, they seemed to contradict.

[sattygirl99]

Well it really depensd on the MW i think... But I know that when my husband was looking to leave for the military before the birth (we've since changed the plans some), my current MW fees would have been $500 after insurance coverage ($3800 global fee) plus $700 for the birth assistant.

You'll have to find a MW that can bill tricare... not all of them can.

Good luck!!!

[mbhf]

Since you live in an area with a lot of military, your best bet would be to call some of the CNMs and ask them if they have success billing Tricare and how much clients generally have to pay out of pocket.

[lovemyzoo]

Two ways to go about this. One the easiest way is do they have OB on post? You can get a referral for a CNM that is set up to use tricare(which in a state that CNM do homebirth it is up to them to do the paperwork) and then they will cover everything. This is typically easier to do if there is no OB on post or the OB is very limited.
Other option and for CNM most common is to go to tricare standard and see her that way. Then you will have copays and cost but the cap is 1,000 for the year so it isn't that bad. But again all your medical will have to be off post.
That is the easiest two ways and if you were going to get tricare to cover a birthing center then odds are you will be able to get a CNM referral and pay nothing as long as you find one that is tricare provider. Which you can typically look on the tricare website to find one.

[Rose_S]

I went through this back in 2007. Yes, lots of contradictions with Tricare. I had a home birth back in July 2007 and went back and forth with Tricare on what they paid. Depends on the day and which person at Tricare you talk with on what answer you get.

I can just tell you how it worked for me. I did Tricare Standard and had a homebirth with CPMs in TX. The CNMs billed Tricare for me. Tricare says they only pay CNMs, but they did pay my CPMs. However, in 2007 the TRICARE Maximum Allowable Charges allowed for Vaginal delivery with prenatal/postnatal visits was only $1200. So TRICARE only paid $1200 and said that should cover ALL prenatal and postnatal and the birth. Really??? My midwives would have lost money on that deal, with all the time they invested in me, so the rest we paid out of pocket. They were worth every penny!

Here is a very good site you should look at: http://www.tricare.mil/allowablecharges/ "On this site you will find the TRICARE Maximum Allowable Charges (TMAC) for the most frequently used procedures or services. These charges are the maximum amounts TRICARE is allowed to pay for each procedure or service and are tied by law to Medicare’s allowable charges.
We are providing this information so that you may be aware of what TRICARE is currently allowed to pay for various medical procedures or services before you see a provider. These amounts do not reflect TRICARE Beneficiary out of pocket cost shares, co-payments, deductibles, or payments made by any other Health Plan Coverages." Just enter your zip code, then you can scroll through all the pages to see what Tricare will pay. The "Non physician office" category is what Tricare considers home birth. I see that the rates for "Non physician office" Vaginal delivery with prenatal/postnatal visits has increased and is now $1,430.15. It is better than nothing!

Hope this helps!!