any military mamas get tricare to pay for homebirth?

[tandemmama]

I know there's no hope of it happening for me, but a mama-friend in Texas is pg and planning a homebirth and is interested to find out how some mamas got tricare to cover it.

anyone have luck with this in TX?

[applejuice]

I'd be interested also.

[kama'aina mama]

I did. I spelled out the whole thing in the Tribal Area thread "Military Moms" which may be archived by now. I will find a link. In any case, what it will come down to is this: Is the midwife a legally licensed provider? If so, s/he can be paid, under the same rules as any other out of program service provider.

About half way down on this page. http://mothering.com/discussions/sho...0&pagenumber=1

I got $1000 reimbursed after paying $1600 out of pocket, plus they paid for my external version, which was a whole seperate fight. Best of luck!

[tandemmama]

Thank you so much!

did you get this to work in Tx or in the same tricare region as TX? I know things vary by region...in our region, they won't pay midwifes period, homebirth, hospital, rotation with ob's in a practice. no negociation. but I know that other regions don't have that rule.

I'm going to forward all of this to her! thanks so much

[kama'aina mama]

I was in Virginia at the time, which is Mid-Atlantic Region. I'm not sure how they can stick by a policy like that. If midwifery is being legally practiced and they are licensed by the state to deliver babies they have the same status as any other healthcare provider. If you can jump through the flaming hoops of Tricare to go out of service they should pay. What branch is your friend? I ask because some branches have volunteer spouses trained to help others with getting through this kind of complexity.

[tandemmama]

Her dh is army. (well, he's still delayed entry, but he's going army) I don't know how they can have this crazy no midwife law here either..it makes abosolutely no sense. I'm using a lay midwife who is NOT licensed by the state, so it's not worth fighting in my case. However, if I were using a CNM...I would be fighting it!

I read your post, but I'm not sure I understand one thing..how do you get them to approve a provider that's not on their "list"? Can't they make you use a provider on their list or refuse to pay? or is this one of the differences between tricare prime and standard?

[kama'aina mama]

I think some of the rules I posted are different than the rules when my babe was born. They are (on paper anyway) being far more aggresive about forcing you to come to the military hospital. I expect there are ways around that. You could try to find out what the borders of the "military hospital catchment area" is and make a point of living outside them. Or at least have an address of record outside them.

My understanding (and if this isn't on point to your question, tell me) is that Prime is like an HMO: You use our facilities, our docs, period. Like Kaiser or something. Standard is more like a PPO: Here is the list of our docs, if you go to them we pay X% with a Y deductable, if you go off the list you pay a higher % and a higher deduct but we will pay. So based on that, if you go Standard they should pay any licensed medical provider. But like I mentioned, they are trying like crazy to herd all us brood mares into the military corral, so they keep throwing up additional roadblocks.

Let's do this, we'll ask around here and maybe you can ask around among military families you know in person if anyone is on Standard and see if we are understanding correctly how it works.

[tandemmama]

great idea! I think I have a neighbor on standard. and I suppose a call to the tricare office might do some good as well.

She won't have a problem with getting away from the military facility since the facility she lives near doesn't do prenatal care or births, so she'll have to go to a civilian..even with prime.

[kama'aina mama]

Also, in the Military Momma's thread in Tribes on the last page there was just a brief discussion of Standard. Best of luck to your friend.