As soon as you think you may be pregnant, visit your primary care manager (PCM). If your PCM is not an obstetrician, your PCM will refer you to an obstetric physician to manage your pregnancy.
Active duty service members
You should receive all care from a military treatment facility (MTF), if available. When enrolled in TRICARE Prime, you’ll be referred to a civilian network provider only if MTF care is not available. If you are enrolled in TRICARE Prime Remote and have an assigned PCM, your PCM will direct your care; otherwise, you may obtain care from a civilian TRICARE-authorized/certified provider with prior authorization from Humana Military Healthcare Services (Humana Military).
All other TRICARE Prime enrollees
If you are a TRICARE Prime enrollee, you’ll receive your maternity care in the MTF, if available. If care is not available in the MTF, your PCM will refer you to a civilian network provider and Humana Military will work together with you to find a civilian network provider that meets your family’s needs. You can always use the point-of-service (POS) option to receive care off-base, but POS fees will apply.
TRICARE Prime Remote for Active Duty Family Members
When enrolled in TRICARE Prime Remote for Active Duty Family Members, your PCM and Humana Military will assist you in finding a civilian TRICARE-authorized/certified provider.
Yes - TRICARE covers all necessary maternity care from the first obstetric visit through labor, delivery and post-partum care for up to six weeks after the birth of the child - including the treatment for any complications that may occur during your pregnancy.
Fetal ultrasounds to determine the sex of your baby (or otherwise not medically necessary)
Services and supplies related to non-coital reproductive procedures
Off-label use of FDA-approved drugs to induce or prevent labor, unless there is reliable evidence that such use is a generally acceptable medical practice
Home Uterine Activity Monitoring (HUAM), telephonic transmission of HUAM data or HUAM-related telephonic nurse or physician consultation
Unproven procedures unless there is reliable evidence that such procedures are a generally acceptable medical practice
Yes. You can see the same provider throughout your pregnancy unless you request a change. If you relocate during your pregnancy, your PCM and Humana Military will coordinate with your new provider to make sure you get the care you need.
While TRICARE does not specifically cover private rooms or other comfort items, many military facilities offer private postpartum rooms as well as other personalized services such as individualized prenatal education, lactation support and stork parking.
You’ll continue to receive postpartum care, generally for up to six weeks after your baby is born. You can schedule these appointments directly with your provider.
TRICARE Prime will cover your newborn immediately after birth and for the next 60 days, as long as at least one other family member is enrolled in TRICARE Prime or TRICARE Prime Remote. To ensure your baby remains covered by TRICARE Prime after the first 60 days:
Step 1: Register your baby in DEERS
To register your baby, visit a uniformed services identification (ID) card-issuing facility. If you’re not near a military base, visit www.dmdc.osd.mil/rsl to find an ID card-issuing facility near you. You do not need an official birth certificate to register. All you need is a certificate of live birth authenticated by a U.S. hospital or MTF.
Although you do not need your new baby’s SSN to register the child in DEERS, you should report the child’s SSN to DEERS as soon as it’s obtained from the Social Security Administration to ensure on-going eligibility for medical care.
You can call the Defense Manpower Data Center Support Office at 1-800-538-9552 if you have questions about registering your newborn in DEERS.
Step 2: Enroll your baby in TRICARE Prime
Enroll your baby in TRICARE Prime within the first 60 days. On day 61, if you have not enrolled your baby in TRICARE Prime, he or she will be covered automatically under TRICARE Standard and Extra until 365 days after the birth.
Visit the Enrollment Portal or call 1-800-444-5445 for assistance. If you pay enrollment fees, and the baby changes your enrollment from a single to a family plan, your enrollment fees will increase to the family member rates.
TRICARE offers well-baby and well-child care for your newborn up to age 6. Well-baby/well-child care includes:
Circumcision
Routine newborn care
Comprehensive health promotion and disease prevention examinations
Vision and hearing screenings
Height, weight and head circumference
Immunizations
Developmental/behavioral appraisal
You’ll schedule your baby’s first well-baby appointment before you leave the hospital.
Note: In certain cases, your baby may not be eligible for TRICARE coverage. Contact Humana Military or a Beneficiary Counseling and Assistance Coordinator (BCAC) to confirm eligibility.
CHCBP is a premium-based health care program administered by Humana Military. CHCBP offers temporary transitional health coverage (18-36 months) after TRICARE eligibility ends. If you qualify, you can purchase CHCBP within 60 days of loss of eligibility.
TAMP offers coverage for up to 180 days to certain active duty service members and their eligible family members when the sponsor separates from active duty.
