New Baby on the Way? Get Ready with TRICARE

9/17/2020

Is the size of your family about to grow this year? Planning for a new baby can be a fun and exciting time in your life. But the thought of maternity costs and maintaining a healthy pregnancy can be stressful. That’s why it’s important to understand your health care needs and your coverage. As a TRICARE beneficiary—and expectant mother—you have access to maternity care coverage before, during, and after you give birth.

Here’s a look at how TRICARE covers maternity care and how you can prepare as you approach your delivery date.

Prenatal Care

Prenatal care is the care you receive from the time you find out you’re pregnant until you deliver your baby. Early and regular prenatal care is vital to the health of you and your baby, according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development. As soon as you think you may be pregnant, schedule an appointment with your health care provider. Depending on your health plan, this may be your assigned primary care manager (PCM). During your checkup, your doctor may perform an ultrasound or antepartum services, like a fetal stress test, to monitor your baby’s health.

Your TRICARE plan may determine the type of birthing facility you’ll use. You also have different options for the type of provider who delivers your baby, like an obstetrician or a family practice provider. This is something you may discuss during your prenatal visits. Be sure to talk to your TRICARE contractor if you have questions about covered services or providers. In overseas locations, there may be exceptions to certain coverage limitations.

Labor, Delivery, and Post-partum Care

Once it’s time for labor and delivery, TRICARE will cover your medically-necessary services. This includes anesthesia, fetal monitoring, Cesarean section (C-section), if needed, and other services required for your care during your stay. After delivery, you’ll usually stay in the hospital for a minimum of 48 hours—96 hours if you have a C-section. However, you may have to stay longer if you have complications.

After your baby is born, you’ll receive post-partum care to ensure your body is healing properly. TRICARE covers a minimum of two post-partum visits. More visits will be covered if you have complications or if your doctor thinks it’s needed.

Maternity Costs

Did you know that your maternity care and costs depend on your beneficiary status, location, and TRICARE plan and provider? For TRICARE to cover your care, you must use a TRICARE-authorized providerAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. DS. According to the TRICARE Maternity Care Brochure, “Active duty service members and active duty family members have no costs for maternity care under any TRICARE Prime option.” Others beneficiaries may have copayments and/or cost-shares. This includes retirees, their family members, or those enrolled in:

As your pregnancy progresses, remember that pregnant women might be at an increased risk for severe illness from COVID-19. The Centers for Disease Control and Prevention recommends that you protect yourself using these healthy habits:

  • Wash your hands with soap and water.
  • Use hand sanitizer with at least 60% alcohol, if soap and water are unavailable.
  • Limit your interactions with other people as much as possible.
  • Wear a face mask whenever you’re in public and can’t maintain 6 feet of social distance.

Did you know that the birth of your child is a TRICARE Qualifying Life Event? Be sure to review the information on getting coverage for your newborn and take advantage of the maternity care services available to you and your family. Take command of your health, and get ready to welcome your new bundle of joy to the world.

At the time of posting, this information is current. For the most recent information, contact your TRICARE contractor or local military hospital or clinic.

Last Updated 10/14/2021