Tricare and Pregnancy – Prenatal, Pregnancy & Birth, Postnatal

Expecting a bundle of joy? This guide informs you what's covered under Tricare -- before, during, and after pregnancy.
Advertising Disclosure.

Advertiser Disclosure: Opinions, reviews, analyses & recommendations are the author’s alone. This article may contain links from our advertisers. For more information, please see our Advertising Policy.

The Military Wallet has partnered with CardRatings for our coverage of credit card products. The Military Wallet and CardRatings may receive a commission from card issuers. Some or all of the card offers that appear on The Military Wallet are from advertisers. Compensation may impact how and where card products appear, but does not affect our editors’ opinions or evaluations. The Military Wallet does not include all card companies or all available card offers.

Tricare Pregnancy & Prenatal Coverage
Table of Contents
  1. Tricare Pregnancy Coverage
    1. Tricare Prime vs. Tricare Select
  2. Tricare Pregnancy Coverage: How Much Does it Cost to Have A Baby With Tricare?
  3. Tricare Prenatal Coverage
    1. Does Tricare Cover Midwives or Doulas?
  4. Tricare Labor and Delivery Coverage
    1. How Much of My Hospital Stay is Covered Under Tricare?
    2. Tricare Birthing Center Coverage: Are Birthing Centers an Option?
    3. Tricare Home Birth Coverage
  5. Tricare Postpartum Coverage
    1. How Do I Enroll my Baby in Tricare?
  6. Tricare Pregnancy Coverage: Key Takeaways

The idea of welcoming a new baby into the world can be exciting and scary.

You’ve got so much to prepare for, hormones to handle, and the constant hustle and bustle of the military to worry about. One thing that shouldn’t be stressful is understanding your Tricare pregnancy coverage.

By reading this guide, you’ll learn what’s covered under Tricare before, during, and after your pregnancy. Keep reading to learn more.

Tricare Pregnancy Coverage

As a beneficiary, maternity care is covered before, during, and after pregnancy by Tricare Prime and Tricare Select. But what exactly does this cover involve? Are there co-pays? Are there circumstances that Tricare won’t cover? Keep reading to learn more about all the coverage details.

Tricare Prime vs. Tricare Select

Active-duty spouses have options when it comes to coverage:

  1. Tricare Prime
  2. Tricare Select

When it comes to maternity care, there are some differences between Tricare Prime and Tricare Select.

Suppose you are covered under Tricare Prime and want maternity care. In that case, you must get your pregnancy confirmed by your primary care physician (PCM) before receiving any prenatal care from a military hospital or an in-network facility.

With Tricare Select, Tricare Reserve Select, Tricare Retired Reserve, and the Continued Health Care Benefits Program, you do not need a referral to begin prenatal care. All you have to do is find a network provider (if you don’t already have one) and call to schedule your first prenatal appointment.

Whether you are using Tricare Prime or Tricare Select, your first prenatal appointment (sometimes the second under Select) is when your doctor will:

  • Collect your medical history
  • Order labs
  • Start scheduling future appointments

Tricare Pregnancy Coverage: How Much Does it Cost to Have A Baby With Tricare?

If you are enrolled in a Tricare Prime plan, there is no cost to you for medically necessary maternity care.

If you are enrolled in any other Tricare program, you may have copayments or cost-shares.

Generally, under Tricare Select, active-duty spouses or Tricare-eligible daughters will pay between $50 and $150.00 as a deductible, depending on the sponsor’s rank. For inpatient stays, the cost is about $14 a day.

Considering trying to get pregnant? Talk with your primary care physician and learn more about coverages from Tricare. Prenatal pills, for example, are covered under your Tricare plan.

Tricare Prenatal Coverage

Tricare defines prenatal care as the “care you receive from the time you find out you’re pregnant until you deliver your baby”.

They cover several services during pregnancy, including services to determine how healthy the baby is or if your pregnancy is considered high risk. These include:

  • Chorionic villus samplingcells from the placenta are check to see if they have any chromosomal abnormalities like Down syndrome.
  • Amniocentesis your doctor may recommend that a small sample of amniotic fluid be removed from your uterus for testing for fetal abnormalities like cystic fibrosis or spina bifida.
  • Cordocentesis during this procedure, an ultrasound transducer is used to find the fetus’s location and the umbilical cord on a monitor. Once located, a fetal blood sample is drawn from the umbilical cord to test for any possible fetal abnormalities.
  • Fetal stress testingafter 34 weeks, this test may be done to check if your baby will stay healthy during labor contractions.
  • Electronic fetal monitoring continuously recording the heartbeat of the baby during labor.

Tricare also covers:

  • High-risk or complicated pregnancies.
  • Ultrasounds that are considered medically necessary — determining the sex of the baby is not covered under Tricare.
  • Lactation counseling, a breast pump, and pumping supplies.

If you’re unsure about prenatal coverage, never be afraid to ask questions. Contact your Tricare provider with any concerns you may have.

Does Tricare Cover Midwives or Doulas?

If you would like to have a midwife during your pregnancy, it is an option under Tricare. In order for Tricare to cover the services, the midwife must be:

  1. State-licensed
  2. Certified by the American Midwifery Certification Board — in some cases, midwife services may be covered by a registered nurse who is not CNM certified but is referred and supervised by a physician.

Lay midwives, Certified Professional Midwives, and Certified Midwives are not covered by Tricare.

Tricare Labor and Delivery Coverage

Hospital stays can get costly, especially when you’re having a baby; thankfully, Tricare pregnancy coverage includes all medically-necessary services like:

  • Hospitalization for labor and delivery
  • Anesthesia during labor and delivery
  • Monitoring
  • Vaginal births
  • Medically necessary cesarean births
  • Postpartum care
  • Other medically necessary services/treatments

Keep in mind that if you’ve chosen to have a cesarean section instead of a vaginal delivery for personal reasons, and it is not required, Tricare may bill you for some of the costs.

How Much of My Hospital Stay is Covered Under Tricare?

Your entire stay will be covered under Tricare as long as it is deemed medically necessary. If you are not enrolled in Tricare Prime, co-payments may be required.

NICU and pediatric critical care stays are also covered under Tricare.

Tricare Birthing Center Coverage: Are Birthing Centers an Option?

Tricare covers deliveries at birthing centers if:

  1. It is a Tricare-certified birthing center
  2. You are stateside

Tricare Home Birth Coverage

If you are considering a home birth, know that it may be covered by Tricare if you are stateside.

Tricare Prime members do not pay anything for home births as long as it is within the parameters of Tricare’s requirements. If you are a Tricare Select patient and choose to have a home birth, you may have to pay 20 percent of the allowable charges. For more information about Tricare home birth coverages, costs, and requirements, contact your regional contractor.

Tricare Postpartum Coverage

Under Tricare, a minimum of two postpartum visits with your doctor are covered. If you’ve had any complications, or your provider simply thinks you need more care, coverage will continue.

Tricare also covers treatment for postpartum depression and other postpartum related issues. Never be afraid to discuss any symptoms or issues you have postpartum with your physician as there are many resources available to you.

How Do I Enroll my Baby in Tricare?

For the first 60 days of your new baby’s life, he or she is covered as a Tricare prime beneficiary as long as one family member is enrolled in Tricare Prime. After the initial 60 days, any claims submitted for medical care will be processed under Tricare Standard.

As a parent, you have up to 90 days (120 days in stationed overseas) to enroll your child into the Defense Enrollment Eligibility Reporting System (DEERS). Still, we recommend you do it as soon as possible so that you don’t forget.

To enroll your baby in DEERS, a birth certificate and a DD1172 form should be submitted to your sponsor’s personnel office. The personnel office will also need your child’s social security number, but they understand that sometimes applying for and receiving a social security number isn’t a quick process.

Tricare Pregnancy Coverage: Key Takeaways

Although we cannot fully prepare you for parenthood, we can assure you that understanding your coverages will take some of the stress out of the new chapter you are in.

Whether you’re covered under Tricare Prime or Select, Tricare pregnancy coverage is not something that should cause you additional stress, as long as you have your bases covered. Being aware of coverages and discussing any concerns you have about coverage with your physician, or a Tricare representative can save you time — and sanity — so that you can enjoy this brand new chapter in life.

About Post Author

Get Instant Access
FREE Weekly Updates! Enter your information to join our mailing list.

Reader Interactions

Leave A Comment:

Comments:

About the comments on this site:

These responses are not provided or commissioned by the bank advertiser. Responses have not been reviewed, approved or otherwise endorsed by the bank advertiser. It is not the bank advertiser’s responsibility to ensure all posts and/or questions are answered.

The Military Wallet is a property of Three Creeks Media. Neither The Military Wallet nor Three Creeks Media are associated with or endorsed by the U.S. Departments of Defense or Veterans Affairs. The content on The Military Wallet is produced by Three Creeks Media, its partners, affiliates and contractors, any opinions or statements on The Military Wallet should not be attributed to the Dept. of Veterans Affairs, the Dept. of Defense or any governmental entity. If you have questions about Veteran programs offered through or by the Dept. of Veterans Affairs, please visit their website at va.gov. The content offered on The Military Wallet is for general informational purposes only and may not be relevant to any consumer’s specific situation, this content should not be construed as legal or financial advice. If you have questions of a specific nature consider consulting a financial professional, accountant or attorney to discuss. References to third-party products, rates and offers may change without notice.

Advertising Notice: The Military Wallet and Three Creeks Media, its parent and affiliate companies, may receive compensation through advertising placements on The Military Wallet; For any rankings or lists on this site, The Military Wallet may receive compensation from the companies being ranked and this compensation may affect how, where and in what order products and companies appear in the rankings and lists. If a ranking or list has a company noted to be a “partner” the indicated company is a corporate affiliate of The Military Wallet. No tables, rankings or lists are fully comprehensive and do not include all companies or available products.

Editorial Disclosure: Editorial content on The Military Wallet may include opinions. Any opinions are those of the author alone, and not those of an advertiser to the site nor of  The Military Wallet.