TRICARE Expands Childbirth, Maternity Benefits Via 5-Year Trial Program

TRICARE Expands Childbirth, Maternity Benefits Via 5-Year Trial Program
Photo by Airman 1st Class George Goslin/Air Force

A five-year program offered to TRICARE Prime and Select beneficiaries will expand coverage for growing families to include non-medical labor doulas and a wider range of breastfeeding and lactation support programs.

 

The TRICARE Childbirth and Breastfeeding Support Demonstration runs through Dec. 31, 2026, and would cover six doula visits before or after the birth along with a visit during the birth. The doulas must be certified by one of five organizations: BirthWorks International, Doulas of North America (DONA) International, Childbirth and Postpartum Professional Association (CAPPA), International Childbirth Education Association (ICEA), or toLabor, according to a DoD notice published in the Federal Register.

 

“While doula services typically aren’t covered by commercial health plans, the emotional and physical support they provide during pregnancy, childbirth, and the postpartum period is particularly important for servicemembers and military spouses who are often geographically separated from their partners and extended family,” said Karen Ruedisueli, MOAA’s director of government relations for health affairs. “MOAA appreciates Congress and DoD launching this demonstration project to assess the effectiveness of additional support in improving the quality of care and maternal and infant outcomes within the military health system.”

 

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TRICARE already covers lactation counseling, but the new program will allow trained non-medical personnel to participate as consultants. It also adds coverage for group breastfeeding counseling as part of the six outpatient lactation sessions covered per birth.

 

Expanded provider options may increase beneficiary use of the program – only 5% of new moms used the lactation support benefit in FY 2020, defense health officials told Military.com.

 

The Fine Print

Beneficiaries can visit their TRICARE regional contractor homepage (East | West) for more details on the program. Some details on eligibility and requirements:

  • Expecting mothers must be 20 weeks pregnant to use the doula services and 27 weeks pregnant to begin lactation counseling.
  • Program participants cannot plan to give birth in a military treatment facility (MTF), though some MTFs may allow patients to bring doulas to assist during labor.
  • The program will not be available to overseas beneficiaries until Jan. 1, 2025.
  • Only TRICARE Prime and Select beneficiaries are eligible. The pilot program is not available to those under the U.S. Family Health Plan, the Continued Health Care Benefit Program, or TRICARE for Life.

 

A full breakdown of the benefits, including links to more eligibility information, is available on TRICARE’s website.

 

Have you used the program, or do you know someone who’s taken part? MOAA is seeking feedback from those who’ve participated as part of our ongoing efforts to track beneficiary access to, and satisfaction with, their earned health care benefits. Email legis@moaa.org with details on your experience.

 

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About the Author

Kevin Lilley
Kevin Lilley

Lilley serves as MOAA's digital content manager. His duties include producing, editing, and managing content for a variety of platforms, with a concentration on The MOAA Newsletter and MOAA.org. Follow him on Twitter: @KRLilley