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Thread: Bill question! Hospital delivery w/ Tricare Standard-Extra

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    #1

    Bill question! Hospital delivery w/ Tricare Standard-Extra

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    I have Tricare Standard/Extra. Husband is active duty. I'll be delivering our baby soon at a civilian hospital. Was wondering for those who have been in my shoes... what bills can we expect to receive in the mail after it's all said and done? I know Tricare Prime = no bills, but what about Tricare Standard?
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    #2
    I'm pretty sure they have all that info on thier website , like the fees ect
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    My confusion is this: I was told that we would be responsible for 15% of all services rendered, and would end up paying up to the $1000 deductible for the fiscal year, then Tricare pays the rest for the year's medical bills. So with this information, I should have been getting charged a co-pay for every visit to my civilian OBGYN (because there are no military doctors at our current duty station) However, I haven't had to pay a cent to my doctor! The only places I've had to pay anything, are like $5 for prescription medications I've needed through pregnancy, and $25 or so for every visit to my high-risk specialist. So this information really tells me nothing... will I get a 15% bill from the hospital, will I not? Can't seem to find an answer. Kind of stressful.
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    #4
    It might be that your civilian doc is slow about billing. I saw someone in like Dec for a regular OBGYN checkup and they still haven't billed me...
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    Here is the link for a pretty good fact sheet:
    file:///C:/Documents%20and%20Settings/Administrator/My%20Documents/Downloads/Maternity_FS.pdf
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    #6
    You may want to move this to a different section other than parenting to get a better response.

    If memory serves (from what others on this website have said), you don't pay any co-pays for pregnancy while on standard. However, I don't recall anything mentioned about how much you would pay for delivery.

    So, the no co-pay makes sense.


    For future reference.. if you do not have an MTF (medical treatment facility) within like 40 miles of your duty station and you are on prime, you can still see a civilian doctor.

    I have been prime for the entire 20 years... and until we moved here never got seen at an MTF, because the AF doesn't have hospitals on their bases, only clinics and small clinics at that. Moving here, its a high military location, and even though I go to an MTF, my doctor at the MTF is still civilian.

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    What section could I move it to? And yeah... the copay thing confuses me too. Seems every doctor's office handles me differently, every Tricare rep tells me something different (or so generic that I don't understand), and to top it all off... the copays I've been having to pay my high risk specialist, we've been getting reimbursement checks in the mail from Tricare for.... huhhh?
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    #8
    You don't pay copays for pregnancy. Were you to go to the Dr for something unrelated to your pregnancy than the fees and deductible and all that would apply. You will be billed for your hospital stay at something like $17 a day but that's it.
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    #9
    I would move it to Military Benefits or Pregancy.. but a Staff member will need to move it for you..


    Is the 15% you got and deductible specific to pregnancy, or is that amount in general for all medical?

    Again, from what i've heard, there are no copays for pregnancy, and (like maegan said) the delivery bill shouldn't be very much.

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    #10
    I just got my bill from having my bebe in Feb on Standard and it was $53. We were in the hospital Mon-Thurs.

    ETA: Also, prenatal care from your regular ob/gyn should be no co-pay after your first visit. First visit is a 15% co-pay, so that charge would have depended on what services were provided at the first visit. My first kid, the charge was so very very low (like 3 bucks or something) that the office waived it, so I never paid anything. Third kid I paid like $150 or something because my first visit on Standard included a TON of stuff due to timing.
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