Summer 2004
If you are thinking about choosing to receive maternity care at a civilian facility, the National Military Family Association offers some tips. Among them:
In some areas around military installations, finding a civilian obstetrician who will accept TRICARE may be a problem. Before you decide where to receive maternity care, find a civilian provider with whom you are comfortable and who accepts TRICARE.
If you want to disenroll from Prime in order to receive maternity care in the civilian sector, be aware that ALL care will fall under the rules of TRICARE Standard. Maternity care for active-duty families is considered one episode from prenatal care through the six-week post-partum visit and the charge is the greater of the daily subsistence rate in a military hospital or $25. Beneficiaries who disenroll from Prime may not re-enroll in Prime for one year unless the military sponsor receives PCS orders or is an E-4 or below.
Your newborn automatically will be eligible for TRICARE at birth and will be enrolled in Prime for 120 days if any other family member is a Prime beneficiary. The newborn retains eligibility for TRICARE for one year from the date of birth, but reverts to TRICARE Standard co-payments if not specifically enrolled in Prime by the 120th day.
All newborns should be enrolled in the Defense Enrollment Eligibility Reporting System (DEERS) as soon as possible after birth to avoid any problem with claims payments. For further details, go to www.tricare.osd.mil.
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