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Pregnant :) Now considering Tricare Standard!

who's talking here?

sweetcheeks 1
Barbie 2
accountnickname 2
IrishDeLight 1
DaniP 3
Maleficent 8
namenotalreadytaken 1
a3051493uu 2
SunnyLove 1
USMCvetandwife 1

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a3051493uu --- 9 years ago -

I just found out that I am pregnant-went to the naval hospital and took the test and what not. I was wondering what the process was to switch to standard-not really enjoying the naval so far. What kind of out of pocket expenses are there? And any suggestions of places out in Town? We live in Bonsall CA 

sweetcheeks --- 9 years ago -

My BFF did it and she couldn't be happier 

Maleficent --- 9 years ago -

Maternity is covered 85% for in network. Hospital stay is $17.50/night. You pay nothing until after
You have the baby. I just switched and I see Sally Lang at Scripps Encinitis. She's a certified midwife. I adore her! Out of network is 80% covered. There is a $150 deductible but again that won't be until after you have baby. No copays or anything except with prescription meds. You will need to find a primary care doc in town too. 

Barbie --- 9 years ago -

Maternity is covered 85% for in network. Hospital stay is $17.50/night. You pay nothing until after

I paid $16 a night...
Do NOT have your baby at the Fallbrook hospital!! It was the biggest mistake of my life! My son is now two and we are still going through drama with them over what they failed to notice with my son. It seriously almost cost my son his life!!! I'm not even extraditing, the surgeon at Balboa was furious when they finally life flighted him there. 

Maleficent --- 9 years ago -

Barbie when did you have your baby?

If you google Tricare Maternity and click on the link that says "Tricare Maternity Care Fact Sheet" It will tell you everything. It's a PDF you have to download and open. It says $17.05 not $17.50 my bad but either way. It was updated May 2012. If you pay less, lucky you but be prepared to pay what they say they are going to charge.

Or if you click this link it will let you download it. :)

Maternity Fact Sheet 

Maleficent --- 9 years ago -

 

Barbie --- 9 years ago -

Your right Maleficent, I had him right before that. Next I'll look before I type bad information ;) 

DaniP --- 9 years ago -

Remember we switch from tricare and new changes start on the April, 1 so make sure they coverage is the same. 

Maleficent --- 9 years ago -

Remember we switch from tricare and new changes start on the April, 1 so make sure they coverage is the same.

It is. The coverage is the same across Tricare no matter which company is servicing a region. The only changes are made globally. So us changing companies doesn't change anything with coverage. 

DaniP --- 9 years ago -

Okay, from my understand there would be changes. I thought tricare was being replace (or bought out) like what happened with dental. ? 

Maleficent --- 9 years ago -

No. For everyone in The west region for Tricare we are going from Triwest to United Healthcare (I believe) but nothin changes except who the referrals/authorizations etc get faxed to and where you look up info online.

Dental is seperate. I can't remember the companies but that changed globally. Everyone that used Tricare dental when the companies changed had different coverage. Tricare dental doesnt have regions. With the medical change, the west region is the only region that is changing companies because no other region used Triwest. The coverage doesn't change. 

DaniP --- 9 years ago -

Okay. Thanks. I just didn't want her to change and (because i thought there was changes) it would come back and bite her in the butt. Glad you know more about it than i do. :) 

Maleficent --- 9 years ago -

I just changed in Jan so I went through all this withthe tricare reps. They are very helpful. 

accountnickname --- 9 years ago -

When did maternity on Standard go from 100% coverage other than the hospital stay copay to only 85% coverage? 

IrishDeLight --- 9 years ago -

I was receiving "care" at CPNH up until last week, when I went to Balboa. In the last week I have switched to a doctor in Balboa and finally feel good about the care I'm getting for my pregnancy. It may be a bit of a drive, but for the care I'm receiving... It's night and day and I no longer have endless questions- my Dr. At Balboa is wonderful! 

Maleficent --- 9 years ago -

2012 I'm guessing? 

a3051493uu --- 9 years ago -

Im nearly positive that Im just going to do the inital check at the naval and then switch over to a civilian doctor with standard. I live in Bonsall(near Fallbrook) Im looking for a good obgyn/midwife. Where were you seen/and where did you deliver? 

accountnickname --- 9 years ago -

I just wanted to add that I was able to look at the fact sheet and most women will not pay 15%. The 85% coverage is only for those choosing to deliver at home (midwife) or as an outpatient (birth center). Maternity care resulting in an inpatient delivery (in a hospital) are still covered 100% except for a $17.05 per night copay (%25 minimum) plus a deductible based on rank ($50 for E4 and below and $150 for E5 and up). What I can see has changed since I used standard for my pregnancies was that I don't believe I had to pay the deductible. 

Maleficent --- 9 years ago -

It does read that way doesn't it! The lady on the phone said it was for all maternity care except the delivery but she could be wrong.

Im delivering at a birthing center in San Diego though with a CMW so I'll still have the 15% (or 20% if they aren't in network) 

SunnyLove --- 9 years ago -

Thanks for posting this guys!!!! At least we know we do have options that are affordable. And no one is stuck seeing drs on Pendleton. 

USMCvetandwife --- 9 years ago -

We have had me on TriCare standard since we have been married (3.5yrs) and the rates just keep going up and up. I like the freedom, but if you have to go to the doc regularly it is very spendy. Yes, they cover a percentage except they keep changing how much they pay the doc, which in turn changes how much you pay. You pay a $150 deductible EACH TIME, PLUS the percentage for any costs after the $150. It may be great for your pregnancy just to be on the safe side, but you may want to consider changing back if you do have to go to the doc regularly. I am a veteran and had the most horrible experience in the Marines with the docs. Had to fight 3 darn years to get hip surgery that was needed the whole time. The day before the pre-op the Navy doc sent his corpsman in to tell me the doc cancelled the surgery, there's nothing wrong with me, and to go PT more... like I was faking it! I was so pissed. Long story short, I was able to go out in town and had to see 3 hip specialists before finding the one with the ability to do the surgery. All 3 docs were amazed how I'd dealt with the pain the whole time because they could see the tears on the films from the military docs... the ones that said "negative" for tears or abnormalities. Craziness... If you fight for your care on Prime it is the way to go, but there are politics sometimes. On standard you have the freedom to go wherever you want... but you PAY for that freedom. My prescriptions aren't free either and some of them run $75/mo! In that sense, I miss Prime. Good and bad to both. Kudos for reconsidering the quality of military expertise during your pregnancy. After that, re-evaulate your own situation and go from there... we are currently paying $175/wk out of pocked just for a chiropractor and that doesn't even begin to show you how much we pay a month for dr bills and prescriptions. Lots to think about!!! 

namenotalreadytaken --- 9 years ago -

Does anyone who used standard with a non-network provider have an estimate of how much they ended up paying for everything? Or a total of about how much was spent?

Thanks 

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