FALLS CHURCH, Virginia –
Are you an expecting parent? Are you thinking of having a child?
TRICARE is now providing more options to those who are planning to expand their family. As of Jan. 1, TRICARE added new childbirth and breastfeeding benefits under the Childbirth and Breastfeeding Support Demonstration, or CBSD. CBSD is for those enrolled in TRICARE Prime and TRICARE Select in the U.S. under one of the TRICARE regional contractors.
As part of this five-year study, TRICARE covers the services of three new types of TRICARE-authorized providers:
- Certified labor doulas
- Certified lactation consultants
- Certified lactation counselors
“With the CBSD, we’re evaluating the cost, quality of care, administrative feasibility, and the impact on birthing parents and infants of using trained, non-medical professionals as extra maternal health providers,” said Erica Ferron, management and program analyst with the TRICARE Health Plan. “At the end of the study, TRICARE will review the findings and then decide whether or not to make this coverage permanent.”
Both benefits are only for TRICARE Prime and TRICARE Select enrollees. And you must use civilian providers. This means the CBSD isn’t available at military hospitals and clinics. It’s also not available if you have coverage through:
You don’t need referrals to use network providers. If you have TRICARE Prime, you’ll need a referral from your primary care manager to see a non-network provider. Without a referral, you may have point-of-service charges.
What are these new services? How can you qualify?
Certified labor doulas
TRICARE will cover up to six visits by certified labor doulas, either before or after you give birth. You also get one doula visit for the length of your delivery. These doulas are trained professionals who provide non-medical support for birthing parents. (A doula is a professional labor assistant who provides physical and emotional support to you and your partner during pregnancy, childbirth and the postpartum period.)
“TRICARE is breaking new ground by covering doula services,” Ferron said. “The support services provided by certified labor doulas will complement maternity services by TRICARE-authorized physicians and other medical professionals.”
TRICARE is creating a network of certified labor doulas. You can use a doula outside of the network. But you must make sure your doula still meets the CBSD qualifications for you to get reimbursement.
To qualify for doula visits, you must:
- Be at least 20 weeks pregnant
- See a TRICARE-authorized provider for your birth event
As part of the CBSD, you can’t plan to give birth in a military hospital or clinic. But you can give birth with a certified nurse midwife at home if that midwife is a TRICARE-authorized provider. If you don’t use a midwife who is authorized by TRICARE, the CBSD won’t cover the services.
Lactation consultants, counselors
As outlined in the TRICARE Maternity Care Brochure, TRICARE covers breastfeeding counseling, as well as breast pumps and supplies. With the CBSD, TRICARE is expanding that coverage. There are many lactation consultants and counselors who are highly trained, but not fully licensed medical providers. Expanding coverage to these providers will help you have more access to qualified lactation experts.
The CBSD also adds coverage for group breastfeeding counseling. These sessions count toward the six total allowed outpatient counseling sessions you have per birth event.
To qualify for this extra coverage, you must:
How can you enroll in the CBSD? If you’re eligible, you’re automatically enrolled when you submit a claim covered under the CBSD. You can also check with your TRICARE regional contractor to see if you qualify. If you need help finding a provider, talk to your regional contractor.
The CBSD goes until Dec. 31, 2026 stateside. It will expand to overseas and U.S. territories in January 2025. If you want to learn more about CBSD, check out the Childbirth and Breastfeeding Support Demonstration page.