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News | March 31, 2022

Make Sure Your Midwife Service Is Covered by TRICARE Overseas

By TRICARE Communications

Childbirth is one of the most beautiful moments in a person’s life. It can also be one of the most stressful. Many families choose to hire a midwife to help them through the childbirth process. Midwife services are also an important part of the medical culture in many places overseas. The type of certified midwife you choose will determine if TRICARE can cover the services.
 
“TRICARE only covers midwife services provided by a midwife who meets certain criteria,” said Cindy DiLorenzo, chief of the TRICARE Overseas Program Office. “If you live overseas and plan to use a midwife, you can work with International SOS Government Services, Inc., the TRICARE Overseas contractor, to find a midwife that’s covered by TRICARE. If you choose a midwife who isn’t covered by TRICARE, you’ll pay the entire cost of the midwife services.”
 
A midwife is the traditional care provider for mothers and infants. Midwives are trained professionals who support women before, during, and after childbirth. There are several types of certified midwives. TRICARE covers services provided by a certified nurse midwife (CNM). The CNM must be:
  • Certified by the American Midwifery Certification Board
  • Licensed by the local licensing agency as a midwife where the care is provided (when required)
 
TRICARE doesn’t cover midwife services by lay midwives, certified professional midwives, or certified midwives. If you receive services from a midwife who isn’t a CNM, they must be a registered nurse who is referred to and supervised by a licensed physician. The doctor must also provide onsite supervision during the delivery. This must be documented in your claims submission. If not, you won’t be eligible for reimbursement.
 
How can you find a CNM in your area? Contact the TRICARE Overseas Program Regional Call Center for help with finding health care services and the needed referrals. The call center can also check the qualifications of local midwives. This will ensure your midwife meets the requirements needed for reimbursement by TRICARE. If you have the MyCare Overseas app, you can also use it to help find network providers in your area.
 
Are you planning to give birth at home? Overseas beneficiaries don’t normally have home birth options because of the certification requirements for a midwife. You should contact your TRICARE Overseas Program Regional Call Center for specific guidance. TRICARE does cover inpatient hospital visits for labor and delivery. It also covers postpartum care. TRICARE will also cover any medically-necessary services you need for your labor and delivery. Some of these services include:
  • Anesthesia for pain management
  • Fetal ultrasounds
  • Cesarean section (C-section) if needed
 
If you don’t live overseas, stateside beneficiaries who receive services in the 50 United States and the District of Columbia can have a CNM present for delivery at several locations, as outlined in the TRICARE Maternity Care Brochure:
  • TRICARE-authorized hospital
  • TRICARE-authorized birthing center
  • Planned delivery at home
 
Do you have questions about other maternity costs? Your costs depend on your beneficiary status, location, TRICARE plan, and provider. Active duty service members and active duty family members have no costs for maternity care when enrolled in a TRICARE Prime plan, including TRICARE Prime Overseas and TRICARE Prime Remote Overseas. Other beneficiaries may have copayments or cost-shares or both. You can use the TRICARE Compare Cost Tool to view costs for each plan.
 
For more information on childbirth and maternity services, use the What’s Covered tool on the TRICARE website. And if you’re looking for a midwife overseas, remember to use a midwife that meets TRICARE’s criteria. Contact your TRICARE Overseas Program Regional Call Center if you have questions.
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