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Terribly confused, Tricare *YES I SEARCHED*

who's talking here?

YouReallyThinkSo 3
gorgeousll19 1
DocsWife 1
Pulga 6
luvmymonkeys3 1
accountnickname 2
DaniP 1

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Pulga --- 13 years ago -

I've read past threads...

Currently pregnant, I am being seen in NH due to Tricare Prime, (current doc I am seeing seems very unknowledgeable, and not only my Vag but my womb feels in crisis) I want to be seen off base, I've read from some of the ladies on here that I can get a referral to be seen off base for another PCM/to give birth outside of NH? Is that even possible? Or am I completely delusional? Any positive help would be greatly appreciated. 

DaniP --- 13 years ago -

Call Tricare! 

DocsWife --- 13 years ago -

You either have to, by some miracle, get Tricare to approve you being seen by a civilian provider. You'll have to fill out forms and write a letter stating why you should be approved. Or you can switch to Tricare standard, and pay some small copays, but be able to choose your doctor off base. 

Pulga --- 13 years ago -

I just spoke to the Tricare prime guy and he left me super confused. If I do switch to standard we'll meet the 150 deductible, plus having to pay 20% of labor. What's the point of meeting a deductible and then having to pay more for labor, etc.

Yay! Confusion. 

YouReallyThinkSo --- 13 years ago -

Tricare will not approve you to be seen out in town. If you want to be seen out in town you have to switch to standard. I would recommend it. I delivered on base recently and it was horrible. But everyones experience is different. 

accountnickname --- 13 years ago -

If I do switch to standard we'll meet the 150 deductible, plus having to pay 20% of labor. What's the point of meeting a deductible and then having to pay more for labor, etc.

No. The only charge on standard for the entire maternity care and the delivery is a $17.05 charge per day (but $25 minimum) for each day you are in the hospital. That is it. Anyone who tells you differently is wrong. I've used standard for four pregnancies so that I could be seen by the provider of my choice. 

Pulga --- 13 years ago -

Yikes, what doc did you have Youreallythinkso? 

gorgeousll19 --- 13 years ago -

I have standard and love it. I delivered my 3rd child at a birthing center. I paid $75 up front but after all said and done they sent me a check for almost $100. 

Pulga --- 13 years ago -

What birthing center gorgeous? 

YouReallyThinkSo --- 13 years ago -

I had a midwife at the naval hospital her name was Lt Dell. She didnt delivery my baby, but I wasnt a fan of hers ether. There is a thread about the one that delivered my baby it was done about a week ago, it was Lt something. I forgot but if I heard it I would know. Let me check and see if I can find the thread. What doc did you see at the NH? 

YouReallyThinkSo --- 13 years ago -

Ok I was wrong, the person that delivered my son was Commander Stewart. I had complications, that werent her fault. It was the doctor that was on early in the days fault but I didnt like the way she handled them. Also she was not gentle at all, she was in a rush to do everything and very rough. 

Pulga --- 13 years ago -

Blank is his name. We were supposed to schedule lab work and also a follow up ultrasound for my 20th week. As I asked him a question in regards to contact info (since its with tri city for some strange reason) as we asked if we may have a number to call..... He just walked out, didn't say anything and didn't come back..........

I had to ask the nurse if we were all done, to which she said yes. My husband and I left confused and disappointed.

Which led me to call Tricare, and here.

I did wind up calling a second time and this rep actually confirmed that I'd be covered for labor, I'd only pay the 17.05 for each night spent at the hospital, and the early visits being 15% copay. So all in all....... I'm glad I got help from you guys and also from the rep at Tricare! Now I can start the process and get on standard! 

accountnickname --- 13 years ago -

and the early visits being 15% copay

Not unless you plan a home or otherwise outpatient delivery. Read the maternity fact sheet I linked you to. The entire global maternity fee is covered by tricare standard 100% minus a $17.05 per day copay for hospitalizations. If you will be delivering in a hospital go to the second chart under standard on the maternity fact sheet and is specifically shows that it is for all prenatal care, delivery, and newborn care and there is no separate cost-share. If you plan to deliver in at home or as an outpatient (not counting a birthing center) you will have a $50 deductible for E4 and below, $150 for E5 and up PLUS 15% cost share. The copays are ONLY for prenatal care that will not end in hospital or birthing center delivery and are not billed as a global maternity fee. 

Pulga --- 13 years ago -

Oooooooooooh ok. Me gets. Thanks! 

luvmymonkeys3 --- 13 years ago -

You can ask the naval hospital to release you from care and the civi ob can see you. I did it with my pregnancy. 

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