Join the Meeting Place for Moms!
Talk to other moms, share advice, and have fun!

(minimum 6 characters)

Military Families Military Families

If you have used Tricare standard for maternity or pediatric care...

Posted by on Jan. 16, 2013 at 12:45 PM
  • 28 Replies
I called Triwest yesterday and spoke to a super nice and helpful guy but I wanted to run what he told me in here and see if that matches up with what you all have actually experienced.



Maternity care- He said that it was a $150 deductible for my 1st appointment with my midwife or OB and then $17.05 for each day I am in the hospital to deliver the baby. He said that everything else was covered 100% under the Global Maternity Authorization. I talked to the birthing center I will be going to and they do accept Tricare Standard.



Pediatrics- He said there was a $150 deductible per child OR a $300 max deductible per family. We have 4 kids (it will be 5 in August) and he said we would just need to meet the $300 deductible for everyone, not a $150 deductible for each child. Then, after the deductible is met Tricare pays 85% and we pay 15% of any other medical costs.



Does this sound like what you actually experience? It sounds like a pretty good deal to me and I want to make sure I am not overlooking anything. He also said that as long as my husband remains active duty we no longer have to be on Standard for a year but we can return to Prime at any point if we decide we aren't happy.

Thanks!
Posted on the NEW CafeMom Mobile
by on Jan. 16, 2013 at 12:45 PM
Add your quick reply below:
You must be a member to reply to this post.
Replies (1-10):
JMmama
by Kara on Jan. 16, 2013 at 10:13 PM
Shameless bump...
Posted on the NEW CafeMom Mobile
usmclife58
by Nikki on Jan. 16, 2013 at 10:18 PM
1 mom liked this

I swear I replied to this one you first posted.... I don't know where it went :(

The figures sound right. I didn't use it but for a secondary insurance when I was on Standard, so I can't say for sure.

SierraLynn
by on Jan. 17, 2013 at 10:21 AM
I know things have changed recently. I had my daughter almost 5 months ago and I was on standard for almost the whole pregnancy. The only thing I paid for was $34.09 for my hospital stay. Basically paid for the food. Everything else was covered 100%, there was no $150 deductible for my first appointment...
But like I said I know things have changed recently with standard....
Posted on CafeMom Mobile
SierraLynn
by on Jan. 17, 2013 at 10:22 AM
And I got back on Prime when we went and signed my baby up for it as well. So ibwas on Standard for only about 6 months.
Posted on CafeMom Mobile
Dani_Lynn
by on Jan. 17, 2013 at 10:28 AM
For pediatric, yes. And vaccines are covered at 100%.
Posted on the NEW CafeMom Mobile
AleaKat
by on Jan. 17, 2013 at 10:30 AM
Almost 6 years ago when we had it I paid a $20 copay for my first OB visit and that was it.
I paid nothing else.
Posted on CafeMom Mobile
ArmyBride04
by on Jan. 17, 2013 at 4:21 PM

We have only had TriCare Standard. We love it--I don't have to have a referral for everything and I get to choose my provider (it's cheaper if you pick an "in network" provider).

My first daughter I paid $44 total to have her. I never paid a copay
My second daughter was $25 (I didn't stay as long in the hospital). I can't remember paying anything else for her (she was born in late 2011).

As for peds, I'm not sure how the cost share works. If it's just a regular Dr. visit I usually get billed $10-$20. I don't pay a copay at the office. The only annoying thing is, sometimes for infant visits they will bill me for multiple visits in one bill, so it seems like more, but it's really like 3 visits (but that's a Dr. thing). Immediate Care is more, like $50 a visit.

If you don't got to the Dr. very often, it's the way to go (IMO).

usmclife58
by Nikki on Jan. 17, 2013 at 4:37 PM

Is that new? I did have to pay for all of Lucy's vaccines. It wasn't much though. I think it was like $30 or something.

Quoting Dani_Lynn:

For pediatric, yes. And vaccines are covered at 100%.


lizzielouaf
by Bronze Member on Jan. 17, 2013 at 5:19 PM

$34.09 was all you paid? Do you mean for the entire pregnancy and delivery? 


Quoting SierraLynn:

I know things have changed recently. I had my daughter almost 5 months ago and I was on standard for almost the whole pregnancy. The only thing I paid for was $34.09 for my hospital stay. Basically paid for the food. Everything else was covered 100%, there was no $150 deductible for my first appointment...
But like I said I know things have changed recently with standard....



SierraLynn
by on Jan. 17, 2013 at 5:34 PM
Yes, for the entire thing. I also made sure my OB was a network provider.

Quoting lizzielouaf:

$34.09 was all you paid? Do you mean for the entire pregnancy and delivery? 



Quoting SierraLynn:

I know things have changed recently. I had my daughter almost 5 months ago and I was on standard for almost the whole pregnancy. The only thing I paid for was $34.09 for my hospital stay. Basically paid for the food. Everything else was covered 100%, there was no $150 deductible for my first appointment...

But like I said I know things have changed recently with standard....




Posted on CafeMom Mobile
Add your quick reply below:
You must be a member to reply to this post.
Join the Meeting Place for Moms!
Talk to other moms, share advice, and have fun!

(minimum 6 characters)

close Join now to connect to
other members!
Connect with Facebook or Sign Up Using Email

Already Joined? LOG IN