Tricare information

[Guest KC]

We live at Columbus AFB and there are a lot of students who make the decision to have a baby. I second the idea mentioned above that it is much better to have a baby towards the end of pilot training than the beginning. Everyone here usually goes with Prime. There are no OB/GYN's on base. The flight doctors will do routine OB exams, but after you confirm a pregnancy with them, they send you off base. There are not a lot of choices here for OB/GYN doctors so I'm not sure how much being on Tricare Standard during a pregnancy would benefit anyone at Columbus. I'm on Prime so I can't say.

Tricare Prime: If you are pregnant, the nurse will give you a referral to see a doctor of your choice off base for the duration of your pregnancy as long as that doctor accepts Prime. Everything is paid for except for private rooms unless that is all that is available at the hospital. Also, you will pay a portion of prescription costs, but a small amount.

Tricare Standard: You pay part of the costs, much like regular civilian insurance. You have a bigger umbrella of doctors to choose from, but with a pregnancy this could add up. Anyone on here ever have a baby on Tricare Standard? If so how much did it run you?

Good Luck!

[Boxhead]

My wife & daughter are on standard now...no maternity experience just yet, but we looked at that. There is a bunch of legal mumbo jumbo to read through, but the gist is this:

You pay a $200(ish) deductible

After that, you have co-pays

There is a $1000 per year cap....eg, no matter what happens, your out of pocket costs will never be more than $1000...that is the deductible and all the co-pays added up.

It does not matter (out of pocket cost wise) if the costs are for maternity, annual appts, ER visits, whatever.

My suggestion, go onto the TRICARE website, it gives handy-dandy little charts about the specific differences between each program. Then, call the TRICARE office of the base you are going to. Also ask your sponsor...the TRICARE office does not always give the best info. Towing the party line is not what you want done when it comes to the healthcare of your family.

Best of luck!

[The Kayla]

I'm on standard, and I love it. Yes, it's more money, but I like the freedom that I have picking a docotr that I wante, and being able to set up an appointment, and not having to do the same-day appointment BS(I just had to go through that at Maxwell..)

The tri-care website will give you great information, if you can go on base, and they have a tri-care Rep at the Hosp/clinic(like Maxwell did) you can go there and talk to them.

I do know more people who have their kids on Standard due to the "same day appointment" BS.

With me being "standard" if I'm out of my home area, and I need to see a Doctor, I can go straight to Urgent care, and not have to call tri-care and get an approval first-- you do with Prime. If I have to go to the ER, I have to call with in 24hrs to let tri-care know i went.. (I went to the ER the night of Dec. 26th and I went to Urgent care on March 10th, while I was in Maxwell".

The only "crappy" part about standard-- is if you are on base, you are only seen by a doctor if there was a cancellation-- you are on stand by to see a doc at base. But, if you are out of your home area, just go to Urgent care..

Also, if you can, go to teh family supprt-mumble jumble(they keep changing the name) and ask them questions as well, they SHOULD know/have answers and if they dont, they should know who to send you too... the family support deals with new spouses, so that would be your best place to go for ANY information about the AF in general.

Being on Prime or standard is your call, you need to do what ever is best for you and your family. Me being on Standard, I have more control over my doctors and who I see and when I see them.. on prime, you aren't always that lucky.

[Guest vicki1205]

I had Tricare Prime with both babies, two c-sections, complications, etc., got excellent care and never paid a dime. It was the way to go for us.

[Guest jojo61397]

Count me in those who are against having a child at the beginning of UPT. If you have fertility problems, it WILL add extra stress. Not that I'm saying make decisions based on furthering DH's career, but I do know a thing or four about fertility issues. It took me three years to conceive my first. Anyway, I would wait until the end of pilot training or even the beginning of your first flying tour. UPT, track select, and subsequent training can mean a lot of moves, it would be better for your pregnancy if you wait until you are at your first base. JMHO, take it or leave it.

Maternity coverage is good in the military, except for u/s. If you want more information on pregnancy in the military and tricare coverage go to www.babycenter.com/bbs, under moms and dads like you, working and staying at home links, there is a military family link.

[broncoflyer05]

This is all hypothetical at this point as my wife and I are not sure she is pregnant yet, but I start pilot training in August and would go into Tricare Prime then, would her maternity costs be covered since she would be pregnant before going on coverage? I had a friend who had trouble getting insurance to pay for the costs since he wasn't covered before his wife became pregnant, that is why I ask. I couldn't find any clauses for coverage, just curious if anyone knew.

[The Kayla]

This is all hypothetical at this point as my wife and I are not sure she is pregnant yet, but I start pilot training in August and would go into Tricare Prime then, would her maternity costs be covered since she would be pregnant before going on coverage? I had a friend who had trouble getting insurance to pay for the costs since he wasn't covered before his wife became pregnant, that is why I ask. I couldn't find any clauses for coverage, just curious if anyone knew.

If you start UPT in August, then I would think that would mean that you are considered an Active Duty member now, possibly on Casual status? and if that's the case, then when you enrolled her in DEERS(she needs to be enrolled in DEERS to get her ID card), the default to putting people on Standard, and it's her job, or your's, to switch her over to prime-- but until you switch her over to prime, she's covered on Standard. She'll have to stay on Prime for a year, from when she switchs over from Standard to Prime.

another idea: Play stupid-- act like you guys dont know she's PG-- It's not uncommon for women not to know that they're PG until 6-9wks along. and just assume that their bitchiness is because of stress, work, husbands not doing what they are told ;), etc. you get the jist.

Edited June 29, 2007 by Kayla

[Guest wannabeflyer]

I'm a newly commissioned 2lt out of AFROTC waiting to go to flight training. right now my EAD date is in august. I signed some sort of form saying i have medical coverage through the air force from the time i commission to when i go on active duty. my sgt. said to just keep the bills and i'll be reimbursed. does anyone have any experience with this or know if there's a way to get them to pay upfront because i might have to have something done that will be expensive. I called tricare and deers people and they essentially told me that i didn't have coverage until i entered active duty.

[Guest Rainman A-10]

I think you got some bad poop.

[Whitman]

I think that's true, you don't have coverage until you EAD. Why did you sign a paper saying you already have coverage while you're waiting to go AD? If you really do, why not use that? Are you talking about dad's retirement military healthcare or what? More info. Best bet is to call cadre, hopefully they'll know.

[The Kayla]

You need to take the form that you signed, saying that you had medical, and take it to DEERS, and have them enroll you in Tri-Care. Also, have your orders in hand and be ready to go talk to the Sgt and tell him/her what's going on, maybe they can make a few phone calls to help you out.

Before you have anything done that's expensive, you need to make sure that you are covered for one, and for two, that Tri-Care will even cover it in the first place.

Good Luck!

[LT4Life]

I had to sign something a few months back asking me if I had any bills between commissioning and entering active duty. They said if I did then I could submit paperwork and I would be reimbursed. From what I understand it was something that has been "meant" to be around but wasn't and the Air Force was actually trying to make it right for those that were affected. I didn't have any bills but I was racking my brain for anything I could think of.

[Right Seat Driver]

I'm a newly commissioned 2lt out of AFROTC waiting to go to flight training. right now my EAD date is in august. I signed some sort of form saying i have medical coverage through the air force from the time i commission to when i go on active duty. my sgt. said to just keep the bills and i'll be reimbursed. does anyone have any experience with this or know if there's a way to get them to pay upfront because i might have to have something done that will be expensive. I called tricare and deers people and they essentially told me that i didn't have coverage until i entered active duty.

I had the same issue, you sign a form saying you will or will not have civilian medical coverage after commissioning but before reporting for AD. I stated that I would not, and then I was given Tri Care coverage for myself only. If you have any dependents they are not covered until you EAD. The problem with the Tri Care coverage between commissioning and EAD is that you will pay for things up front and will then get reimbursed (last I was informed).

Your cadre will have an 800 number you can call that will lay everything out for you in regards to Tri Care coverage.

[Guest C-130Wife]

My husband and I are probably going to Little Rock next from Yokota in two years or so. We will be starting a family while we are there. First, does anyone know how the Military handles vaccinations in infants? I am concerned with the rise in Autism and how vaccinations effects that. Second, does Little Rock have the facility to handle births or is it referred to a civilian Dr? I would much rather have a civilian actually. That would possibly weigh my decision on the type of health insurance I carry.

[egochecks]

Don't think there's anything special with vaccinations.

Our son had Hep B at the hospital (off base) and will receive his other immunizations at two months by the base Ped. I think that's standard and if you wanted something different you'd have to ask your specific Ped.

[Guest C-130Wife]

Don't think there's anything special with vaccinations.

Our son had Hep B at the hospital (off base) and will receive his other immunizations at two months by the base Ped. I think that's standard and if you wanted something different you'd have to ask your specific Ped.

Are you aware if that is a requirement? Or do you, as a parent, have the option to forgo any vaccinations? I know you are able to in the civilian world (I was never vaccinated as a child) but I am not sure how the Military runs things. I am new to all of this, just got married 6 months ago! I am not saying I have decided I didn't want my children vaccinated but I just am curious as to what their policy is. Does anyone know?

[pawnman]

We had our baby the week before I started API at NAS Pensacola (not Whiting, I'm a WSO). We used Tricare Prime, got a private room at the hospital on-base, great care the whole time. It was a LITTLE stressful having the kid and starting training right away, but the wife (bless her heart) took care of the kid 24/7 while I had classes and homework. I would chip in when I got home at the end of the day and on weekends, but she was definitely on point until I finished API and went to the pool to await Primary.

I think it worked out nicely for us, because the kiddo was almost two before we made our first move, and she was much more manageable than she was when she was first born.

[egochecks]

Are you aware if that is a requirement? Or do you, as a parent, have the option to forgo any vaccinations? I know you are able to in the civilian world (I was never vaccinated as a child) but I am not sure how the Military runs things. I am new to all of this, just got married 6 months ago! I am not saying I have decided I didn't want my children vaccinated but I just am curious as to what their policy is. Does anyone know?

He was delivered in a civilian hospital and they asked us first if we wanted him to have the vaccination. Not sure what the military policy is. If you're trying to forgo all vaccinations I can't imagine anyone not respecting your wishes although I imagine they might advise you otherwise. I think that the other aspect of not having your child vaccinated while being a military family might cause some issues later if/when you move overseas. I think most countries are going to want to see that everyone has all of the necessary vaccinations. I haven't deployed yet and don't know what the policy is for families in terms of vaccinations though so maybe a parent who has can give you a better heads up on that particular mil/international policy. Or again, your Ped. could probably best answer that question for you.

Edited September 24, 2007 by egochecks

[sputnik]

My wife has been on standard since we got married. I have read the handouts several times and I say congrats to everyone who has figured it out as I sure haven't, the only thing I can tell you is we have paid far less than I think we were supposed to. Max cap is $1000/year as mentioned somewhere above, but we've never even come close. And I really don't know why.

For the peace of mind my wife gets I'm more than willing to pay a grand, but haven't had to. We were happy with our kids' on base ped, but noticed our kids always got sick Friday afternoon and the Tripler ER....wouldn't wish that on my worst enemy. Once we switched to an off-base ped, got to say I was really impressed. Not sure if it was just the fact that he was running a business and trying to keep satisfied customers, or maybe he just cared more, but we got so much better care. Could always get a same day appt, could always reach him (or partner) via phone after hours, he'd call to check on kids a few days after a visit to ensure they were doing okay, the list goes on.

When your kids are born they are automatically on prime regardless of Mom's plan, delivery costs all go against kid. Our first was two months premature (happily totally okay) and our bill was the $13/day for my wife's hospital stay. The $20k he racked up in a great NICU was completely covered.

I get irritated paying bills I feel I "unnecesary" but I'm completely happy paying for standard. Kept my wife happy (worth a lot) but more importantly I've just felt like it's been better care for my family.

[Guest KM]

Thread revival!

I know the BirthWise facility at Enid is now closed, so I'm exploring home-birth possibilities. Does Tricare provide support or coverage for any services like doulas or midwives? I have searched for info but all I have found is that Maternity Fact Sheet, which doesn't offer a lot of help.

ThanksQ!

[Guest Nomadlibrarian]

Thread revival!

I know the BirthWise facility at Enid is now closed, so I'm exploring home-birth possibilities. Does Tricare provide support or coverage for any services like doulas or midwives? I have searched for info but all I have found is that Maternity Fact Sheet, which doesn't offer a lot of help.

ThanksQ!

A great resource is the forums over at mothering.com

https://www.mothering.com/discussions/

Try the Finding Your Tribe board, look under military families. Also, search for Homebirth and Tricare. There is a really comprehensive thread about how to get homebirth paid for by Tricare.

Okay, I just searched for the threads myself.

These are the lots of random info, short threads:

https://www.mothering.com/discussions/archi...p/t-535799.html

https://www.mothering.com/discussions/archi...hp/t-88232.html

https://www.mothering.com/discussions/archi...p/t-647658.html

And this is the Mother of all Homebirth/Tricare threads (pardon the pun):

https://www.mothering.com/discussions/showthread.php?t=598835

If you have any questions after reading all that, head over to Finding Your Tribe and ask the ladies in the Military Families thread there, they are a great resource.

Nomadlibrarian

EDIT: grammar idiocy

Edited March 6, 2008 by Nomadlibrarian

[Guest r6pilot]

It seems that TRICARE is the insurance carrier of the AF. My wife asked me about health insurance once OTS and UPT comes. How does that work? I am currently self employed and she's an RN at a local hospital. Our whole family is on her insurance and once we head off to UPT, she'll most likely have to quit and we'll be out of their insurance.

When does TRICARE kick in? OTS since it's full-time or not until UPT? I'm AFRC if that makes a difference. Also, what are costs these days for a family of four (two adults, two little ones)?

[The Kayla]

It seems that TRICARE is the insurance carrier of the AF. My wife asked me about health insurance once OTS and UPT comes. How does that work? I am currently self employed and she's an RN at a local hospital. Our whole family is on her insurance and once we head off to UPT, she'll most likely have to quit and we'll be out of their insurance.

When does TRICARE kick in? OTS since it's full-time or not until UPT? I'm AFRC if that makes a difference. Also, what are costs these days for a family of four (two adults, two little ones)?

Tricare starts when you enroll them in DEERS.. You'll do this the first week of OTS, and I think it's active the following month. BY the time you move to your UPT base, your whole family will be on Tri-Care.

When you enroll your family, they will enrolled in Tri-Care Standard. Which, works like a regular insurence--You pay co-pays and such.

I strongly suggest that you go to airforceots.com and have your wife check out officerfamilies.com. Even though those two sites are run by Nazis, they do offer great information, and it's all about OTS, with people to walk you and your wife through OTS.

[Guest r6pilot]

Thanks, The Kayla. I'll check it all out now.

What kind of prices are you guys paying these days for a family?

[The Kayla]

Thanks, The Kayla. I'll check it all out now.

What kind of prices are you guys paying these days for a family?

Huh?

Are you talking about co-pays and such?

I think I paid 15%. But it was odd.. it was more expensive for me to see a Dr in the "new Year" because my cap re-started. I'm now on Prime, and since Vance is so small that they just refer you off base for anything "special."

Edited October 26, 2008 by The Kayla