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#121 of 366 Old 06-28-2007, 04:40 PM
 
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I have a question-if you are on Standard and move OCONUS, do you have to switch back to Prime or how does that work? I have no idea what the rules are about homebirthing overseas. :

A supportive military wife and mama to my busy boy and sweet girl.
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#122 of 366 Old 06-28-2007, 04:43 PM
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Originally Posted by StacyL View Post

True Blue - I thought if a MW agreed to the Tricare contract, they could only charge the patient an additional 15% BY LAW, so how is it that any MW's in NY are getting away with charging the patient the extra $5,000 of their exorbitant fees?

I wondered that too. I thought that was the basic purpose of contracting with an insurance company. You agree to accept their rates and they agree that they will send patients to you. Would be curious to know the answer for future dealings for my kids.
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#123 of 366 Old 06-28-2007, 04:44 PM
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Originally Posted by Nicole! View Post
I have a question-if you are on Standard and move OCONUS, do you have to switch back to Prime or how does that work? I have no idea what the rules are about homebirthing overseas. :
I'm not sure where you are going but I know a few people in Germany who switched to Standard and had homebirths. I think it kind of depends on where you are.
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#124 of 366 Old 06-28-2007, 04:48 PM
 
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[QUOTE=True Blue;8498384]I was not complaining about the prices here or saying I can't believe them....I was trying to justify them.

LOL, I got that. I was just trying to express agreement with you. I hear it all the time, about prices, and feel the same way. Compared to what people pay in most of the US, it's crazy what stuff costs in NYC. But, if you are like us, you are used to it, and are astounded by how cheap it is in other parts of the world. I still can't get over how cheap my house was to buy. If you are used to NY prices and saw this place, and what we paid, you'd fall off your chair.B]

QUOTE]

Stacey,

Oh, I didn't see that column. I"m having a hard enough time trying to figure out our own copays and things. This will be my first Tri-Care baby. DH is active duty but will retire in about a year, when he hits 25 years, or 24. I forget. All this has been very helpful, as I'm just having to choose which Tri-care option we need to sign up for, for the first time, and plan a homebirth (not for the first time). DH has always been on Tri-Care Prime, but I think Standard is going to work out best for us, because of all the Doctors the kids see, the birth and other stuff.

Kiley
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#125 of 366 Old 06-28-2007, 05:10 PM
 
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Originally Posted by mom3b1? View Post
All this has been very helpful, as I'm just having to choose which Tri-care option we need to sign up for, for the first time, and plan a homebirth (not for the first time). DH has always been on Tri-Care Prime, but I think Standard is going to work out best for us, because of all the Doctors the kids see, the birth and other stuff.

Kiley
Just an FYI: your status does NOT affect your children's status. If you switch from Prime to Standard for the 12 months in order to do your HB, it does NOT affect your kids in any way.

If your husband is active duty and Prime, your kids should be Prime too, but make sure you fill out the enrollment form. Also, after your HB your baby is AUTOMATICALLY Prime for the first 60 days, but you must fill out the enrollment form before the 60 days are up for the baby to stay on Prime.
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#126 of 366 Old 06-28-2007, 06:42 PM
 
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I don't know if this means anything or not but I know that my referral to a mw was put in as a "global". So I would think if she bills as a global fee then it would be covered. If she bills as "professional services fee" then it may be subject to the extra fees.

Also, I asked *how* they know it is a homebirth (this was when tricare was telling me hb wasn't covered). They said they wouldn't know. The bill would get paid and there just wouldn't be a bill from a hospital. The problem would be if I had to transfer to the hospital and they billed it saying something like a "complication from a hb". Then they would say it wasn't covered. Anyway, most of that turned out to be null and void because hb is covered. But still - how do they know it is a hb, yk??

So like I said I have no idea if any of this holds water but it just makes me wonder.

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#127 of 366 Old 06-28-2007, 09:06 PM
 
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Well, if you make your midwife contract with them...there's also a good chance they just won't contract and then you get NO homebirth.

From what I understand, Tricare does NOT make them contract....just makes sure they are certified and gives an "out of network exception".

Oh and Tricare knows it's homebirth if it's billed that way. There are many different codes for insurance billing.

Amy, USCG wife and homeschooling, ebfing, homebirthing Mama to M (8), L (6), L (2.5)
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#128 of 366 Old 06-29-2007, 05:10 PM
 
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Originally Posted by StacyL View Post
I switched to Standard for my HB and did not pay a dime out of pocket, nor did I have any co-pays for any other medical care because I was never sick or injured. It worked out great!

Good luck!
i also switched to standard & only got reimbursed about 50%.

Jenn, wife to John
Mama to Kayleigh (6), Ethan (4), Norah (1), & Charlotte coming 11.09
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#129 of 366 Old 06-29-2007, 05:45 PM
 
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Originally Posted by Kontessa View Post
So I am in TX and have a military hospital I gave birth at two years ago just down the street. I will not go back there! I have an appointment to meet a midwife, not sure what kind, you think I would know! LOL This Thursday. She said that Tricare will cover it but that they do not bill till after the birth. She said I will have to pay monthy to meet the full amount 2400 and then I will be the one who get the money back from Tricare.

Does this sound right?
this is how my mw does it as well. we pay all by 36 weks ($2500), and then file at the 6w pp checkup. whatever they pay goes in our pocket. i like it that way because i feel better knowing my midwife was paid. they have some clients still not paid up with 3 & 4 year olds.

Jenn, wife to John
Mama to Kayleigh (6), Ethan (4), Norah (1), & Charlotte coming 11.09
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#130 of 366 Old 06-29-2007, 06:14 PM
 
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Originally Posted by True Blue View Post
What have people gotten Tricare to pay $-wise? I .
i think we got reimbursed $1200 of the $2500 we paid.

Jenn, wife to John
Mama to Kayleigh (6), Ethan (4), Norah (1), & Charlotte coming 11.09
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#131 of 366 Old 07-06-2007, 11:40 PM
 
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Please, if anyone is interested in birthing at home with a cpm check out this midwife's website. She is an authorized tricare provider. It has prompted me to see if I can get my midwife to become a tricare provider, as well. www.naturalbeginnings.org(she is in Virginia) and stacy@greatbirth.org or
www.greatbirth.org (these midwives are in Texas).


Quote:
Originally Posted by StacyL View Post
There have been several threads on this here at MDC, but since I just did it here's what I can tell you:

1. Homebirth is only covered by Tricare when using a CNMW - period. No CPM, direct-entry, lay MW's, etc.

2. If you are more than 50 miles away from your MTF (and are therefore on Tricare Prime Remote) then you can have your HB paid for while on Tricare Prime.

3. If you are within 50 miles of your MTF, but your MTF does NOT provide Labor and Delivery Services (for example, Walter Reed Army Hospital) then you can get a referral to a CNMW to have your HB covered while on Tricare Prime.

4. If you are near your MTF and it has the normal L & D services, the only way to get a HB covered is by switching to Tricare Standard. This is very simple - you fill out a single form and mail it in. Then you can see any CNMW that does HB and Tricare will pay for it 100%. There are no co-pays or fees associated with any care you receive related to your pregnancy.

5. While on Standard for a one year period you will be given the lowest priority for appts. on base. You can still try, but they may be hard to get. Otherwise, any medical care OUTSIDE of your pregnancy (e.g. a cold, or ER visit) will involve a co-pay. It is a one-time fee for the ER. No co-pay if you have a second ER visit in the one-year period. The cap on all co-pays for the year is $1,000. That is your maximum possible out of pocket expense for medical care UNRELATED to your pregnancy.

6. You being on Standard does not affect your newborn or other family members - they all remain on Prime.

It really is quite simple, but Tricare does not make it easy to find out this information.

I switched to Standard for my HB and did not pay a dime out of pocket, nor did I have any co-pays for any other medical care because I was never sick or injured. It worked out great!

Good luck!
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#132 of 366 Old 07-07-2007, 08:59 AM
 
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Thanks for the post!

I have seen 2-3 mamas here on MDC say that they got a CPM for a HB covered on Tricare, but I don't think they gave info as to how they did it.
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#133 of 366 Old 07-08-2007, 06:09 PM
 
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I really just don't understand how Tricare can get away with paying so little money to health professionals.

Amy, USCG wife and homeschooling, ebfing, homebirthing Mama to M (8), L (6), L (2.5)
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#134 of 366 Old 07-09-2007, 12:49 AM
 
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Originally Posted by StacyL View Post
Thanks for the post!

I have seen 2-3 mamas here on MDC say that they got a CPM for a HB covered on Tricare, but I don't think they gave info as to how they did it.
I am doing it right now in AR.
AS long as I see a CNM, OB Rn, or OBGYN twice during the pregnancy and they give the referel it is covered. AS long as she is state licenced. It is in Chapter 11, sec 3.11 I don't know your region but if you are in south ask for Erica when you call the hotline, that is who I talked to. I am on prime and staying that way.

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#135 of 366 Old 07-10-2007, 09:15 AM
 
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Well, here in NY they offer a Prime alternative called US Family Health Plan, and I have been informed by them (they have been VERY helpful and done all kinds of legwork for me) that they reimburse up to $5000 around here for birth!!!! And, they will take out of network providers and if their charges are higher than what they will pay out, they negotiate with them to find a middle ground. Looks like I'll be leaving Standard and getting my homebirth fully covered!!!!!

Amy, USCG wife and homeschooling, ebfing, homebirthing Mama to M (8), L (6), L (2.5)
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#136 of 366 Old 07-10-2007, 09:26 AM
 
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Amy!!! This is so wonderful! Congratulations, Mama! I'm so proud of you for sticking with it and finding a solution. What a relief!
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#137 of 366 Old 07-12-2007, 12:40 PM
 
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In order for a CPM to become a Tricare provider, all she should have to do is to apply for a provider #, submit her credentials and state license.

I have spoken with a CPM that did exactly that and became a licensed provider for Tricare.
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#138 of 366 Old 08-06-2007, 04:06 PM
 
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I just called tricare and they said they would pay 100% of my homebirth while still on Prime. The lady told me to see my primary care manager and have him give me an authorization for "Global maternity". She assured me that I'd pay NOTHING out of pocket.

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#139 of 366 Old 08-06-2007, 04:39 PM
 
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Originally Posted by StacyL View Post

But looking at that chart, the rate for a hospital birth on Standard is ridiculous - $535 a DAY for the hospital stay! :
This is only for Retirees and their family members, *not* active duty family members.
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#140 of 366 Old 08-06-2007, 05:06 PM
 
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Originally Posted by StacyL View Post
I disagree with this as I did this. It is a waste of time.

The PCM will say no, and then your only option is to appeal directly to the CO of the MTF.

If you want to do it, then by all means, knock yourself out; but, do yourself a favor and just write a letter to the CO of your MTF requesting the appeal and do not waste a single minute talking to anyone. I guarantee the CO will refuse the referral, but at least you won't waste precious time and energy fighting the underlings.
I got a referral from my pcm to go to a free standing birth center and the MTF refused my referral, saying they had the right of first refusal. Sometimes you can get the referral to only have head of OB at the MTF step in and make that referral void.
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#141 of 366 Old 08-06-2007, 05:20 PM
 
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I just called tricare and they said they would pay 100% of my homebirth while still on Prime. The lady told me to see my primary care manager and have him give me an authorization for "Global maternity". She assured me that I'd pay NOTHING out of pocket.
I simply had to jump in here. I was told the same thing a year ago when we PCSed from CA to NC. I went into the MTF and politely and insistently asked for a Global Maternity referral, and the MTF flat out told me "no", that they didn't care what tricare had to say, they were not going to give me a GMR. I tried EVERYTHING.

It was a terrible, terrible pregnancy care and birth experience. I wish I had known better- I would have switched to Tricare standard and paid the 20% copay.
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#142 of 366 Old 08-06-2007, 05:41 PM
 
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I simply had to jump in here. I was told the same thing a year ago when we PCSed from CA to NC. I went into the MTF and politely and insistently asked for a Global Maternity referral, and the MTF flat out told me "no", that they didn't care what tricare had to say, they were not going to give me a GMR. I tried EVERYTHING.

It was a terrible, terrible pregnancy care and birth experience. I wish I had known better- I would have switched to Tricare standard and paid the 20% copay.
Thanks for giving me a heads up. I'm hoping my doc won't have a problem with it since most of the births at my base end up going to a hospital about 45 miles away anyway. The base is small (mountain home idaho) and the nearest town is Boise, where most active duty wives give birth. If they are going to end up paying for me to go to an outside hospital, why not just let me have my home birth. Wish me luck!

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#143 of 366 Old 08-06-2007, 09:37 PM
 
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This is only for Retirees and their family members, *not* active duty family members.
Yes, I know. We cleared that up some time ago - I was looking at the wrong column.
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#144 of 366 Old 08-06-2007, 09:42 PM
 
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Originally Posted by countrybound View Post
I just called tricare and they said they would pay 100% of my homebirth while still on Prime. The lady told me to see my primary care manager and have him give me an authorization for "Global maternity". She assured me that I'd pay NOTHING out of pocket.
Yes.

TRICARE will pay for it 100% on Prime - that is NOT the problem.

The problem is your MTF. They absolutely, positively WILL NOT write you the NEEDED referral to get a HB while on Prime UNLESS the MTF DOES NOT have L&D services.

It is utterly futile to try and fight your MTF, because as someone downthread stated, they have the RIGHT of first refusal. If the MTF offers L&D services, they DO NOT HAVE TO GIVE YOU A REFERRAL TO HAVE A HB.

This is why it is best to save yourself the heartache, stress, and letter-writing to the MTF's CO, and just SWITCH TO STANDARD!

Switching to Standard makes it painless and hassle-free. And it only costs a $150 co-pay - not a bad deal to avoid a traumatic hospital birth.
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#145 of 366 Old 08-06-2007, 09:44 PM
 
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I got a referral from my pcm to go to a free standing birth center and the MTF refused my referral, saying they had the right of first refusal. Sometimes you can get the referral only to (sic) have head of OB at the MTF step in and make that referral void.
Yes, this is what happens.

You will not get a referral from an MTF that has L&D services. The only option is to switch to Standard.
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#146 of 366 Old 08-06-2007, 09:47 PM
 
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Originally Posted by tessandturtle View Post
I simply had to jump in here. I was told the same thing a year ago when we PCSed from CA to NC. I went into the MTF and politely and insistently asked for a Global Maternity referral, and the MTF flat out told me "no", that they didn't care what tricare had to say, they were not going to give me a GMR. I tried EVERYTHING.

It was a terrible, terrible pregnancy care and birth experience. I wish I had known better- I would have switched to Tricare standard and paid the 20% copay.
I'm sorry you had such a bad experience.

I learned the hard way too. I fought for months with my MTF trying to stay on Prime and get a referral and all for nothing in the end. I wish I had known all I had to do was switch to Standard and how truly easy that was. I did find out in the end, and switched and got my HB, but I wished I had known sooner and could have saved myself months of stress and fighting, which is never fun while pg.
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#147 of 366 Old 08-06-2007, 09:49 PM
 
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Thanks for giving me a heads up. I'm hoping my doc won't have a problem with it since most of the births at my base end up going to a hospital about 45 miles away anyway. The base is small (mountain home idaho) and the nearest town is Boise, where most active duty wives give birth. If they are going to end up paying for me to go to an outside hospital, why not just let me have my home birth. Wish me luck!
Does your MTF not have L&D services? If you are Prime Remote, I think you can get the referral without having to switch to Standard.

But, if you are not Prime Remote and can't get the referral on Prime - don't give up! You can do the switch to Standard and get your HB.

Always speak ONLY to a supervisor at Tricare!
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#148 of 366 Old 08-06-2007, 09:59 PM
 
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Originally Posted by StacyL View Post
Does your MTF not have L&D services? If you are Prime Remote, I think you can get the referral without having to switch to Standard.

But, if you are not Prime Remote and can't get the referral on Prime - don't give up! You can do the switch to Standard and get your HB.

Always speak ONLY to a supervisor at Tricare!
They only have a couple of beds at this hospital. So when they fill up, they send the other moms to Boise. If my Primary care giver won't give me the referal then I'll switch to Standard. I don't think my midwives have an ultrasound machine... did yours? Where did you get your first ultrasound done if you were standard? I'm just asking because I want to see if there is more than one baby ( I'm hoping for twins ) Thanks for all the info.

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#149 of 366 Old 08-07-2007, 12:05 AM
 
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Originally Posted by countrybound View Post
They only have a couple of beds at this hospital. So when they fill up, they send the other moms to Boise. If my Primary care giver won't give me the referal then I'll switch to Standard. I don't think my midwives have an ultrasound machine... did yours? Where did you get your first ultrasound done if you were standard? I'm just asking because I want to see if there is more than one baby ( I'm hoping for twins ) Thanks for all the info.
A "routine" u/s is not even covered by Tricare at all.

But, if your PCM orders one, obviously it is covered and free on base. And I think most PCM's order one. The way I handled it (and the way other Tricare moms have) is to wait until after your u/s to switch to Standard. Otherwise, you would be paying out of pocket for your u/s. Generally, this means you switch to Standard at around 18-20 weeks and then see your MW and bring your u/s and bloodwork records with you.
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#150 of 366 Old 08-07-2007, 12:12 AM
 
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A "routine" u/s is not even covered by Tricare at all.

But, if your PCM orders one, obviously it is covered and free on base. And I think most PCM's order one. The way I handled it (and the way other Tricare moms have) is to wait until after your u/s to switch to Standard. Otherwise, you would be paying out of pocket for your u/s. Generally, this means you switch to Standard at around 18-20 weeks and then see your MW and bring your u/s and bloodwork records with you.
Great that sounds like a plan!

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