Pregnancy Care
Maternity (or pregnancy) care is all of the medical services related to conception and delivery including:
- Prenatal care
- Post-partum care (generally for six weeks after delivery)
- Treatment of any complications
Generally, TRICARE covers all medically-necessary maternity care, but there are some limitations.
Your TRICARE plan may determine where you receive care during your pregnancy. So we can give you the most accurate information, please enter your profile.
Prenatal Care
Prenatal care is the care you receive from the time you find out your pregnant until you deliver your baby. As soon as you think you may be pregnant, schedule an appointment with your primary care provider. Depending on your health plan option, this may be your assigned primary care manager (PCM). Remember, if you are enrolled in a Prime option, you may not self-refer to an Obstetrician or Gynecologist even for your pregnancy.
Regular appointments with your doctor are important to make sure you and your baby are healthy. At the first appointment, you'll find out the due date and explore your health history. Frequent prenatal visits allow you to follow the progress of your pregnancy and your baby's development and give you the opportunity to ask questions along the way.
While all medically-necessary prenatal care is covered, there are some limitations.
Antepartum Services: TRICARE covers the following services to determine the health of the baby or if you have a high-risk pregnancy:
- Amniocentesis
- Chordocentesis
- Chorionic villis sampling
- Fetal stress test
- Electronic fetal monitoring
Ultrasounds: Doctors often perform ultrasounds at different times during pregnancy for different reasons.
TRICARE will cover medically-necessary fetal ultrasounds used to:
- Estimate gestational age
- Evaluate fetal growth
- Conduct a biophysical evaluation for fetal well-being
- Evaluate a suspected ectopic pregnancy
- Define the cause of vaginal bleeding
- Diagnose or evaluate multiple gestations
- Confirm cardiac activity
- Evaluate maternal pelvic masses or uterine abnormalities
- Evaluate suspected hydatidiform mole
- Evaluate the fetus's condition in late registrants for prenatal care
TRICARE does not cover maternity ultrasounds that are not medically necessary (i.e. to determine the sex of the baby.)
If you have ANY questions about coverage, please contact your regional contractor.
Labor and Delivery
TRICARE covers medically-necessary services during your labor and delivery including anesthesia, fetal monitoring, and other services required for your care during your stay. TRICARE will cover cesarean section when needed. If you choose to have a cesarean section instead of vaginal delivery for personal reasons, you may be responsible for some of the costs.
Facility/Provider: Usually, your TRICARE plan determines the type of birthing facility you will use (military or civilian, office-based or freestanding, etc.). TRICARE covers authorized birthing centers.
You also have different options for the type of provider who delivers your baby (obstetrician, Family practice provider and or Certified nurse midwife, etc.). You and your provider will make these types of decisions during your prenatal visits.
Length of Stay: Usually, you will stay in the hospital for a minimum of 48 hours after a vaginal delivery and 96 hours after a cesarean section. Complications may require a longer stay.
Post-partum Care
Post-partum care is the care you receive after your baby is born to ensure your body is healing properly. TRICARE covers a minimum of two post-partum visits. More visits will be covered if you had complications or if your provider thinks it's needed.
Last Modified:September 28, 2012
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