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Tricare Help: Can Tricare Reserve Select beneficiaries get care on post?

Jul. 9, 2014 - 01:38PM   |  

Q. My husband is in the Army Reserve and we are enrolled in Tricare Reserve Select. I prefer to go to the Army hospital on post for emergency room and OB-GYN visits. Iím planning to get pregnant within the next year or two; can I choose to give birth at the military hospital or do I have to go off post? And if I deliver in the military hospital, will the birth be free?

A. Whether a family member may receive health care in a military treatment facility depends on whether the MTF has available space and resources. Each MTF commander makes that call. If you have previously received health care in your local MTF, that indicates the MTF does, in fact, have available space and resources to see Tricare Reserve Select beneficiaries.

However, for beneficiaries in categories that donít qualify for completely free care, MTFs will bill as appropriate. As a TRS beneficiary, your normal TRS cost shares and co-pays would apply should you give birth in a military hospital.

Check with your local MTF on whether that facility can and will support a TRS beneficiary for a childbirth (as opposed to comparatively simple OB-GYN visits). If the answer is yes, the MTF can give you more information on potential costs and billing procedures.

Q. Iím pregnant, and my boyfriend and I plan to marry when he gets back from basic training. Iím a dependent under my motherís Tricare sponsorship. Will the birth be covered? And what about the baby?

A. Your pregnancy and the birth can be covered under your status as your momís dependent. But once your baby is born, it cannot be covered under your motherís sponsorship; Tricare does not cover grandchildren.

However, the baby can be covered under your boyfriendís sponsorship as the father. The baby should be enrolled in the Defense Eligibility Enrollment Reporting System as soon as possible; but newborns technically are eligible for Tricare from birth through their first birthday, even without being registered in DEERS.

For 60 days after birth, theyíre covered under the Tricare Prime managed-care option, as long as one other family member is already enrolled in Prime. All active-duty members must use Prime, so thatís the coverage your boyfriend should have. From 61 to 365 days after birth, babies who remain unregistered in DEERS are covered under the Tricare Standard fee-for-service option, which carries higher out-of-pocket costs than Prime.

Newborns not registered in DEERS after 365 days lose Tricare eligibility until they are registered.

Your boyfriend must handle DEERS enrollment for the baby; you canít do it for him. He can do that at any time after the birth by visiting the ID Card/DEERS office on any military installation. You can also get general information from the main DEERS support office in California. The toll-free number is 800-538-9552.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com. In an email, include the word ďTricareĒ in the subject line and do not attach files. Get Tricare advice any time at www.militarytimes.com/tricarehelp.

Answers by RallyPoint

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