Q. I am enlisted in the Navy and plan to separate in July when I will be 8½ months pregnant. The ex-service maternity care instruction, 32 CFR 728.71, allows me to continue receiving care at a military facility for my pregnancy, but the closest military hospital is 64 miles away — a little far to be driving when I'm about to deliver a baby. I have had Tricare my entire life through my father, who is retired Navy, so I know we have civilian hospitals nearby that accept Tricare. The instruction says nothing about Tricare. Are there exceptions to the requirement that I receive care at a military treatment facility? What do I need to do to receive medical care closer to home? I am 23.
A. Once you separate, the Defense Enrollment Eligibility Reporting System will show you only as eligible for "direct care," meaning you can only receive treatment at a military hospital. According to the instruction, you and your child are eligible for care throughout your pregnancy, labor and delivery, and up to 6 weeks post-delivery. If you decide to go that route, make sure the nearest military hospital offers maternity services and make an appointment before you separate to make sure the hospital can accommodate you.
But the facility cannot refer you to civilian care. If you would prefer to have your baby at a hospital closer to home, you could re-establish your status as a dependent of your father and, after separation, apply for Tricare Young Adult coverage. Tricare would not, however, cover any of the baby's costs once it is born.
You also could purchase coverage through the Continued Health Care Benefit Program within 60 days of losing your military health care eligibility. You would have to pay quarterly premiums and standard deductible and cost shares, but again, CHCBP would not cover any of the baby's costs since the infant wasn't a dependent before joining CHCBP.
If either of your parents is insured through their current employer, you might be eligible for coverage under that plan. Finally, you could consider purchasing coverage through healthcare.gov, with a start date effective the day after your separation date.
Clarification:
A previous column noted that retirees enrolled in Medicare Part A and B — those eligible for Tricare For Life — are not eligible for Tricare Prime. The answer should have said "in most cases, Tricare For Life beneficiaries are not eligible to enroll in Tricare Prime." There are a few exceptions. "Dual eligible" beneficiaries, including those retired and under age 65 who have Medicare Part A and Part B, are eligible to enroll in Tricare Prime if it is available in their area, and dual eligible active-duty family members also can enroll.
Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com. In email, include the word "Tricare" in the subject line and do not attach files.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.
