A few questions...military/tricare/ect

[Melly486]

Will be TT#4 soon and I would like a homebirth, but not sure I can get hubby to agree so also looking into other options. I am NOT giving birth at the hospital here. Too many horror stories. Have not heard one good thing about it.  Anyway, was wondering if anyone here is a military spouse and has used Tricare Standard while pg here in NC.  Anyone know if the Women's Wellness & Birth Center in Chapel Hill is covered by Tricare or if you can choose a different hospital in another town if you switch to Standard? Did any of you have reluctant hubby's when you brought up doing a homebirth and how did you change their mind!? TIA!

[thebassomatic76]

I don't have a whole lot of information that is specifically what you're asking for, but I will share what I can.

I am prior service (retired now, actually), and using Tricare Standard for myself.  Yes, when on Tricare Standard you can choose ANY hospital/provider you choose, with some caveats.  Since I assume your DH is still active duty, your Standard cost shares will be either 25% or 20%.  If you choose a provider/hospital that is IN network, you will pay 20% cost shares, and that is 20% of the *Tricare allowable cost* NOT 20% of what the provider/hospital bills you.  Since they are in network, they have agreed to take the Tricare allowable charge as their fee.  If you choose a provider/hospital that is OUT of network, your cost share will be 25%, still of the Tricare allowable charge, and Tricare states that they may charge you up to 15% (I think) over the TAC which is also your responsibility.  On this part, I am little unsure of how that works...i.e., if they're not in network, how can Tricare in any way manage what they charge you?  You will want to speak to Tricare about that, if necessary. 

You can go onto Tricare's website for your region (North, I think for NC) and do a search for providers available for Tricare Standard and find out who's in network.  You can also just choose your provider and call them directly and ask if they're in network.  Same thing for the hospital you're wanting.  The greatest thing of all about Standard, IMO, is that you don't need a referral or preauthorization for ANYTHING except in patient mental health or substance abuse treatment.  Everything else is YOUR choice at YOUR discretion.

As far as NC, I was on Prime there because I was AD so I didn't have the option of Standard.  I was stationed at SJAFB and had my first child in the hospital in Goldsboro, and it has ruined me on hospital births forever.  I have not had the good fortune of being in an area where homebirths were readily available and accessible, so I can't be sure about this either, but it's my understanding that Tricare will cover a homebirth IF it's performed by a CNM, but will not cover them under any other qualification of midwife, so if there are any CNMs in your area that will attend homebirths maybe that is an option for you.

HTH, and best of luck to you.

[thebassomatic76]

Oh, and don't make this mistake of assuming that providers outside the typical base coverage will/won't be in network for you.  I didn't look into providers too far outside Goldsboro when I was there, because I assumed that most providers who would be in network for Tricare would be concentrated around military bases.  This is not so.  I live almost 90 miles from the nearest military base here, and there are still MANY providers who are both participating and in network with Tricare.  Tricare just won't allow me to be assigned any of these providers as a PCM under Prime, because although they take Tricare and are in network, they are not geographically within the "Prime Service Area" which IS immediately around military bases.

[MommaBirdie]

I don't have answers about the specific place you want to choose.
But I switched to TriCare Standard for my son's birth.
I chose a midwife and gave birth at a birthing center.
I didn't pay one penny out of pocket, when I asked for bills and everything I was told that TriCare completely covers pregnancy and delivery as a universal coverage.

[thebassomatic76]

Originally Posted by MommaBirdie 

I don't have answers about the specific place you want to choose.
But I switched to TriCare Standard for my son's birth.
I chose a midwife and gave birth at a birthing center.
I didn't pay one penny out of pocket, when I asked for bills and everything I was told that TriCare completely covers pregnancy and delivery as a universal coverage.

This may also be true for you, OP.  I know that Standard varies slightly from AD coverage to retiree coverage (one is in the cost shares, yours are 25/20, mine are 30/25), but I can tell you that I've been paying cost shares on all of my prenatal visits so far (I'm 38 weeks right now).

[BirthTender]

There are 8 homebirth nurse-midwives in NC, several out in the eastern and coastal parts, one in Asheville, and myself near Hickory, so finding one for TriCare should not be difficult at all.

Karen Benfield, CNM and owner of BirthTender, a Homebirth, well woman, and family planning practice

Covering roughly a 2 hour radius around Hickory, NC

[Melly486]

Thank you ladies for your help!!

To thebassomatic76 ~ That is where we are stationed, SJAFB. I know two people personally who have had babies at Wayne Memorial and they have friends who have delivered there. I haven't heard anything good. There is a birthing center in Chapel Hill that I plan on finding out if they accept tricare. If not, I have heard of Pitt? Hospital in Greenville? that is supposed to be good. Thanks again for all your help :)

[thebassomatic76]

Yep, Wayne Mem. is where I delivered.  While in the end, I did for the most part have the birth I worked for, there were some bad attitudes and unprofessionalism that I had to overcome in order to do it.  There were ultimately a few other post birth issues for baby and I that resulted, I believe, from the policies and procedures at that hospital, at that time.  I don't know much about Pitt in Greenville, as I never used the hospital.  I saw an OB/GYN there once for non-pregnancy related treatment, and was unhappy.  That was a LONG time ago though, and had nothing to do with their OB practices.  They're probably still worth looking into.  I seem to remember hearing good things about birthing in Chapel Hill, but it's been so long that I don't remember what the details were or who I heard it from. 

Good luck, and I sincerely hope you are able to find the pregnancy and birth care that you are looking for!

[Melly486]

Thank you :)

After replying back to you I was talking to my dh and he told me of a friend of his who almost lost his wife and baby due to some of the policies at Wayne Memorial. I told him if we can't find a good hospital/birthing center I'll just give birth at home!