I spoke with my CNM's billing office and was told that Tricare Standard usually only pays $1,500 to $2,000 for a homebirth. She said that since my midwife is not contracted with Tricare, that I would have to pay the rest of the fees, which would amount to approximately $1,500. out of pocket for me. She also said that Prime doesn't pay much better, and since the midwife is not contracted, I would still have to pay out of pocket.
Has anyone else heard this? I was told somewhere else that as long as I have an "out of network waiver" that I would not have to pay, if I'm on Prime.
Right now I need to decide if this is worth fighting the battle with Tricare to get my auth on Prime, switch to Standard or have a hospital birth fully covered.
I think you are being told incorrectly by your MW's billing dept. I don't believe they can charge you the "difference" either on Standard or Prime. It's against the law. You need to clear that up with your Tricare supervisor ASAP.
Yes, there are several mamas here who have had their HB's covered under Prime Remote like you. CNM's are typically te only ones covered, but there have been a few people who have gotten Tricare to pay a non-CNM.