FALLS CHURCH, Va. –
Are you planning to give birth in the coming months? Do you have TRICARE Prime, TRICARE Prime Remote, or TRICARE Select? Now is a great time to explore benefits that may be available to you through the
Childbirth and Breastfeeding Support Demonstration.
The CBSD covers certain support services and providers not usually covered. The demonstration has been extended through Dec. 31, 2031.
“The CBSD was created to study if services from non-medical labor doulas, lactation consultants, and lactation counselors should be added to the TRICARE benefit,” said Erica Ferron, a management and program analyst for the TRICARE Health Plan at the Defense Health Agency. “Extending the CBSD helps us continue to evaluate how these providers support our pregnant beneficiaries.”
The CBSD is available in the U.S. and overseas. Keep reading to learn how to get services through the CBSD.
Who’s eligible
Eligibility for the CBSD is based on your TRICARE plan and other factors. You must have TRICARE Prime, TRICARE Prime Remote, or TRICARE Select.
For childbirth support, you must:
- Be at least 20 weeks pregnant.
- Plan to give birth outside a military hospital or clinic.
- Use a TRICARE-authorized provider for your birth event.
You must be at least 27 weeks pregnant to get breastfeeding support through the CBSD. If you don’t qualify for CBSD services, you may qualify for TRICARE’s breastfeeding support benefit.
Labor doula services
The CBSD covers services from certified labor doulas. You can get:
- An untimed visit from a certified labor doula while you give birth
- Up to six hours of visits before or after you give birth. You and your doula can split this into 15-minute increments any way you would like.
Note: You can’t get virtual doula services.
Breastfeeding support
To understand how the CBSD covers breastfeeding support services, it’s helpful to know how the TRICARE benefit covers them.
You don’t need to qualify for the CBSD to get these breastfeeding services:
- Counseling you get during inpatient maternity stays, outpatient visits with your OBGYN, and well-child visits
- Up to six individual outpatient counseling sessions per birth event. You must use a TRICARE-authorized medical provider (such as a physician, registered nurse, or nurse midwife), or an outpatient hospital or clinic.
Do you qualify for the CBSD? You have additional options for your six outpatient counseling sessions:
- You can use a certified lactation consultant or certified lactation counselor for individual or group counseling sessions. These providers are non-medical providers.
- You can get group counseling from a TRICARE-authorized medical provider.
Note: You can use virtual breastfeeding support services.
Services in the U.S.
You’re automatically enrolled in the CBSD when you or your provider submits claims for covered services. You won’t have out-of-pocket costs for these services when you use network providers.
Do you have TRICARE Prime? You’ll need a referral from your primary care manager to see a non-network provider. You may pay point-of-service fees without a referral, as noted in the TRICARE Costs and Fees Sheet.
Doula services: You can get services from a network or non-network participating doula. Your doula must sign a participation agreement with your regional contractor. You’ll pay the full cost of doula services if your doula hasn’t signed a participation agreement.
Breastfeeding counseling: You may use a network provider or non-network provider. If you use a non-network provider, the provider may bill you up to 15% of the amount TRICARE pays for your care.
Use your region’s provider directories to find CBSD providers.
Need help finding providers? Call your regional contractor.
Services overseas
You may be able to get CBSD services overseas. You
must register for the CBSD with the overseas contractor before you get services. Register as early in your pregnancy as possible—even if you don’t see CBSD providers in your area’s directory.
“Registering helps us better understand where these services are needed as we build networks,” Ferron said.
Call or email International SOS to register and get help finding providers. International SOS will tell you within 14 days if they can find a TRICARE-authorized provider.
TRICARE is here to support you during and after your pregnancy. Check out the TRICARE Maternity Care Brochure to learn more.
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