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Thread: Freaking TriCare??

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    #1

    Grumpy Freaking TriCare??

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    Okay, so i read online that Tricare dont pay for the 18-20 week ultrasound [gender ultrasound] So I called them and they said unless the doctor says its medically necessary then i cant get one. She also said since Im high risk they will probably pay for it if the doctor says its because Im high risk and they gotta check the babies, but still what if it dont work. IM SO SAD!!!


  2. eres el amor de mi vida <33
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    #2
    Don't get sad about it until you talk to your Doctor. With twins chances are your doctor will tell them its necessary because your high risk.
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    #3
    Really? Tricare doesn't pay for the gender scan?
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    #4
    They will FIND a reason for you to have one, don't worry. Especially with twins. My midwives routinely do it and they will FIND a way to bill it so that it's medically necessary. Don't worry!
    Beth, Mama to Emmalee (12), Evan (9), and Ella (4 on May 7) (I really REALLY need to update my picture!)
  5. Feelin' fly like a Cheesestick
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    #5
    Quote Originally Posted by Abigail View Post
    Really? Tricare doesn't pay for the gender scan?
    They definitely won't pay for it if the REASON is to see the gender. Most doctors do an "anatomy scan" meaning they're checking to make sure all of baby's measurements are on target and everything looks good. They look at lots of stuff... and then they tell you that IF they can see the baby's genitals, they'll tell you the sex.

    Most doctors/midwives know that many insurances don't cover this if there's not a medical indication for this, so they bill it specifically so that it will be covered by the insurance.

    What's interesting to me about Tricare saying it's unnecessary unless there is a medical indication is that every military treatment facility I've heard of does the ultrasound around 20 weeks for every pregnant woman.
    Beth, Mama to Emmalee (12), Evan (9), and Ella (4 on May 7) (I really REALLY need to update my picture!)
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    #6
    When I was pregnant with my second son I didn't get to have an ultra sound until I was 7 months preggo and my doctor put some medical condition down so Tricare would pay for it. I was extremely high risk in my first pregnancy, I had probably 10 u/s during that and we new without a doubt he was a boy. Luckily with my second son the tech managed to find out he was a boy, too.
  7. Happy wife...happy life!
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    #7
    Don't jump the gun. I have yet to hear of a single person who is receiving prenatal care that has NOT had an ultrasound performed...
    Maternity Ultrasounds
    TRICARE covers medically necessary maternity ultrasounds separate from the global delivery fee. Doctors often perform medically necessary maternity ultrasounds at different times during pregnancy, and if your provider has reason for concern, TRICARE will cover the ultrasound. Specific conditions for which TRICARE will cover an ultrasound include the following:

    * Estimating gestational age
    * Evaluating fetal growth
    * Conducting a biophysical evaluation for fetal well-being
    * Evaluating a suspected ectopic pregnancy
    * Defining the cause of vaginal bleeding
    * Diagnosing or evaluating multiple gestations
    * Confirming cardiac activity
    * Evaluating maternal pelvic masses or uterine abnormalities
    * Evaluating suspected hydatidiform mole
    * Evaluating the fetus's condition in late registrants for prenatal care

    TRICARE does not cover maternity ultrasounds for routine screening or to determine the sex of the baby.
    TRICARE Beneficiaries : Covered Services - Maternity Care
  8. Happy wife...happy life!
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    #8
    Also, to SPECIFICALLY do an ultrasound solely for the purpose of identifying gender, I can understand why Tricare wouldn't cover that...
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    #9
    Tricare paid for my gender scan, but that was the only ultrasound I got that wasn't done vaginally. I got it done at 17 weeks.
  10. Hope. It is the only thing stronger than fear.
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    #10
    The 18wk, or w/e week it is you get it, is just to check the baby for everything, like beth said. It's not to tell you the gender. I'm on #3 and have yet to have tricare deny an u/s. Also, with you being pregnant with twins, you'll more than likely have atleast 1 or 2 more after the anatomy scan i bet
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