Join Date: May 2004
Location: Banned - period.
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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!