TRICARE Childbirth and Breastfeeding Support Demonstration

The TRICARE Childbirth and Breastfeeding Support Demonstration (CBSD) covers the following support services:
  • Certified non-medical labor doulas
  • Certified lactation consultants
  • Certified lactation counselors

The CBSD is only for TRICARE Prime or TRICARE Select enrollees. The CBSD doesn’t cover TRICARE For Life, US Family Health Plan, or the Continued Health Care Benefit Program. The CBSD will run from Jan. 1, 2022, to Dec. 31, 2026. The CBSD will expand overseas on Jan. 1, 2025.

You don’t need any referrals. But, if you’re enrolled in TRICARE Prime, you’ll need a referral from your primary care physician or manager if you see a non-network provider. Point-of-service charges may apply without the referral.

TRICARE will release a quarterly “Invitation to Participate in the Defense Health Agency Maternity Survey.” The purpose of the survey is to learn about your experience giving birth in the Military Health System. The survey is confidential and voluntary. TRICARE will send the survey via email to all beneficiaries who give birth after January 2021. You may get the survey even if you aren’t eligible for or choose not to participate in the CBSD.

Childbirth Support and Certified Labor Doulas

How do I qualify for doula services?

To qualify, you must:

  • Be enrolled in TRICARE Prime or TRICARE Select
  • Be at least 20 weeks pregnant
  • See 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 for your birth event
You can’t plan to give birth in a military hospital or clinic as part of the CBSD. You can give birth with a certified midwife at home if that midwife is a TRICARE-authorized provider. The CBSD doesn’t cover services with a midwife that isn’t certified.

What types of doula services are covered?

TRICARE will cover up to six visits by a certified labor doulaLabor doulas are trained, non-medical professionals who provide support for the birthing parent before, during, and a short time after labor.. These visits can be before you give birth or after you give birth. You’ll also get one visit during birth.
  • The CBSD will cover certified network doulas at no additional cost to you.
  • Non-network doulas must meet the CBSD qualifications.

Lactation Counselors/Consultants and Breastfeeding Support

How do I qualify for lactation/breastfeeding support services?

To qualify, you must:

If you or your provider don’t qualify for breastfeeding support services under the demonstration, you may qualify under TRICARE’s existing breastfeeding support benefit.

What lactation and breastfeeding support services are covered?

The following services are covered in the network at no additional cost.

  • Lactation counselors.
    • Non-medical professionals who have received certification to provide breastfeeding counseling to support normal lactation and breastfeeding parents
    • Non-network lactation counselors must meet certain qualifications
    • Can provide either individual or group breastfeeding support services under the demonstration
  • Lactation consultants.
    • Medical professionals who've completed the highest level of breastfeeding training in order to provide a full range of breastfeeding care, including support for breastfeeding complications
    • Non-network lactation consultants must meet certain qualifications
    • Can provide either individual or group breastfeeding support services under the demonstration
  • Group breastfeeding counseling.
    • Individual breastfeeding counseling by other TRICARE providers may already be covered under TRICARE’s breastfeeding benefit.
    • Group breastfeeding must be run by a:
      • Lactation consultant
      • Lactation counselor
      • TRICARE-authorized provider
    • Group breastfeeding counseling also includes prenatal breastfeeding education.

There are no cost-shares, copayments, or deductibles for covered breastfeeding counseling services. Additional charges may apply for out-of-network services.

How do I enroll in the CBSD?

If eligible, you’re automatically enrolled when you submit claims covered under the CBSD. Check with your TRICARE regional contractor to see if you qualify.

How does a provider join the TRICARE network?

For more information on how a provider can join the TRICARE network under this demonstration, please choose your region below.

You can also learn more about rates for Childbirth Support Doula Services.

 

Last Updated 5/6/2024