Tricare Women and Freestanding Birth Center Care: Best Start Birth Center is an in-network PREFERRED PROVIDER with TRICARE. For women with TRICARE Select, receiving midwifery care and giving birth at Best Start is simple—No referral required. However, TRICARE Prime beneficiaries require a referral to get care outside of a Military Treatment Facility and referrals to a Tricare preferred provider for Prime woman have been denied lately, which eliminates an out-of-hospital birth option for some Tricare Prime women, if they are denied a referral.
Due to recent changes in TRICARE’s policy regarding the ability to switch between plan options during pregnancy, getting care at a freestanding birth center may now come with coverage obstacles. Tricare’s policy states Tricare members are not able to make changes to their plans outside of open-season, unless they experience a “Qualifying Life event“, such as relocation or a change in the sponsor’s status.
Earlier this month, TRICARE’s Open Season period ended. During Open Season, beneficiaries can make changes to their plans, choosing to enroll in, or switch between TRICARE’s Select and Prime plans.
Previously, Tricare considered pregnancy a Qualifying Life Event, allowing women to switch plans outside of open-season. As of January 2019, Pregnancy is no longer a qualifying event, so pregnant Tricare women are unable to switch from Prime to Select in order to have the ability to choose the care provider of their choice.
Choosing between insurance plans can be a difficult decision and your needs may change after open-season. Best Start Birth Center supports recent legislation to expand access to birth centers and believes that women should not be blocked from accessing the birth experience they desire.
If you missed the open-season deadline and have TRICARE Prime, there are still options to allow you to birth at Best Start in 2020. TRICARE has a Point-of-Service Option which allows Prime members to see any TRICARE-authorized provider (including Best Start!) in exchange for a cost-share. For Active Duty women, Best Start offers a drastically reduced cash price!
For Best Start, ensuring women have access to out-of-hospital birthing options goes beyond a belief in the freedom of choice. It is a matter of ensuring women have access to options that lead to satisfying and safe birthing experiences.
In the CMS Strong Start Study, Best Start was found to produce excellent results for Medicaid women. The American Association of Birth Centers is currently compiling new data specifically regarding TRICARE women and their outcomes at freestanding birth centers, like Best Start. TRICARE women showed even better outcomes than Medicaid women and we are so excited to share the data once it becomes available!
