TRICARE and homebirth midwives? Military mamas, weigh in!

[eightyferrettoes]

I'm sorta-kinda TTC now, and really have no desire to go back to the MTF where DS was born. But I'd really, really love a homebirth.

I'm on Tricare Prime right now. I know Standard pays for HB, but I also need a Level 2 ultrasound to check for a recurrent genetic syndrome, and would like to have Madigan Hospital (a MTF) do that, preferably without scraping together a copay for that.

All I want is 1) them to pay for the u/s and 2) them to pay for the HB MW. LOL. Anything else is gravy.

I know a woman IRL who had Standard pay for her MW, but she also didn't need or want any sort of expensive testing, which is a complicating factor for me. I'm just afraid that the copays for Standard will break the bank on this one.

Anyways, :blah

TIA!

[nichole]

maybe switch to standard after you have had the test done

but once you switch to standard, you can't go back to prime with the exception of certain ranks (like E1-E4 i think?)

and you know about the catastrophic cap right...the most you will spend is 1000/year/fam for tricare covered services

[jenneyrebecca]

Once you switch to standard, you can't go back to Prime for one year, unless you happen to move within that year and then you can re-enroll as whatever at your new MTF.

I had a homebirth (no pricey procedures, though) and I switched to standard. to be reimbursed, I had to send in my midwife's itemized bill which she gave me at my 6-week checkup. I was reimbursed about $1500 out of the total $2500.

If I were you, I would just call the Tricare 800 number over and over and just talk to the people about what you need. And talk to more than one person, because sometimes they give you the wrong info. I talked to one person who told me ALL I needed to do when my son was born was get him enrolled in DEERS, and it cost us $100 in copays before someone told us we also had to fill out a Tricare Prime enrollment form. You HAVE to just keep asking questions.

It's possible that you could file for reimbursement for your ultrasound, also. I don't know about doing the ultrasound before switching to standard. You might just ask someone at the Tricare # and see what they say. or ask 3 different people. :lol

Good luck!

[eightyferrettoes]

Thanks guys.

nichole, I did not know there was a cap on the amount you can get hit with for a year. That makes a lot of difference... we could probably cough up 1000 over the course of a year.

We almost never go to the doc anyways... a healthy bunch here, so being stuck with Standard for a year should be no big deal, especially if there's a catastrophic cap.

DH's stuff would still be at 100 percent, if I understand correctly, and he's the one who spends the most time at the doc anyways.

jenneyrebecca, that's so true about tricare giving you 3 different answers from 3 different reps. Their customer service suuucks.

I'm really tempted to wait to switch my stuff over to Standard after that u/s, provided I can get a midwife to take me at 17 weeks or so, instead of starting from the very beginning... I'm told they get booked up pretty quick sometimes.

Lots to think about. Thanks, you two.

[Red Sonja]

I think the homebirth has to be with a CNM in order for Tricare to cover it too. I'm paying for my homebirth with a LM out of pocket, but will still submit a claim to Tricare afterwards. No, I don't expect them to cover it, but it doesn't hurt to try.

Good luck!

[Skrimpy]

I think the homebirth has to be with a CNM in order for Tricare to cover it too. I'm paying for my homebirth with a LM out of pocket, but will still submit a claim to Tricare afterwards. No, I don't expect them to cover it, but it doesn't hurt to try.

Good luck!

We had to pay our LM out of pocket, but Standard covered all of the bloodwork and the u/s done at the OB's office. It's been a couple of years ago, though, so I don't know how things have changed.

[Red Sonja]

Yeah, I'm on Prime so I'm getting concurrent care at the MTF. I'll get my bloodwork and ultrasound done there so Tricare will foot the bill.

[eightyferrettoes]

Yeah, I'm on Prime so I'm getting concurrent care at the MTF. I'll get my bloodwork and ultrasound done there so Tricare will foot the bill.

That actually sounds like a really smart way to do it.... that would get me the u/s for free and the midwife's fee out of pocket, instead of paying portions of both...

Hmmm.

[hunnybumm]

Tricare will only pay for a CNM, they won't pay for her assistant or the birth kit. Also, you have to wait a full year if you switch to Standard, the E1 - E4 thing is not for active duty, I tried to play that card. Also, I would get the tests done before you switch over. Just tell your MW your situation and I would bet she wouldn't have a problem with waiting until you are 17 weeks. And the cap is $1000 out of pocket on standard, however it goes by the fiscal year. Which I think starts in October? So you probably want to do your best to get everything covered after the new fiscal year starts that way you have a full year of pretty much free medical.

If you go to the homebirth forum there are quite a few very informative posts about Tricare and homebirth. Post there or do a search.

[Monica]

I am another one paying out of pocket for a LM attended homebirth but going to the MTF for concurrent care to get my screenings/ultrasounds paid for by the Navy. Tricare will NOT pay for LM's only CNM's. I was unable to find a CNM that did homebirths.

Also I think in a similar thread someone mentioned something about switching to standard for pregnancy does not lock you in for a year, that after your 6 week check up you can go back to Prime - I don't know anything about this but it seems to me I read it somewhere. You might ask about this.

[MotheringHeart]

I was on Prime when we lived in CO and had a homebirth, but that was because my CNM friend attended the birth for free. When we moved to Northern VA I switched to Standard so that I could be seen by a midwife. Here's a big secret that NOONE at Tricare will tell you:

If you are Standard and go to an MTF, if they have space they will treat you for FREE!!!

So, it is concevable you could switch to Tricare and see your midwife and just go to the MTF for testing.

Lemme know if you have more questions. I'm kind of a pro at manupulating Tricare.

[ashleyhaugh]

this is interesting.... we're gonna ttc #1 when dh comes home, and ive been thinking about homebirth....

[yotricia02]

If your hubby is oversea's the military will provide a Doula for you. If you can find a doula that will help with a home birth, the military will pay for a doula.

That could be an option.