Prenatal care is important, and we strongly recommend that those who are pregnant, or who anticipate becoming pregnant, seek appropriate medical care. TPR/TPRADFM covers maternity care, including prenatal care, delivery, and postpartum care for women. Newborns are covered separately.
Maternity Ultrasounds
TRICARE covers maternity ultrasounds when medically necessary. Such situations include:
Estimating gestational age
Evaluating fetal growth
Conducting a biophysical evaluation for fetal well-being
Evaluating a suspected ectopic pregnancy
Defining the cause of vaginal bleeding
Diagnosing or evaluating multiple gestations
Confirming cardiac activity
Evaluating maternal pelvic masses or uterine abnormalities
Evaluating suspected hydatidiform mole
Evaluating the fetus’s condition in late registrants for prenatal care
A physician is not obligated to perform ultrasonography on a patient who is a low risk and has no medical indications.
Some providers offer patients routine ultrasound screening as part of the scope of care after 16-20 weeks of gestation. TRICARE does not cover routine ultrasound screening. Only maternity ultrasound with a valid medical indication that constitutes medical necessity is covered by TRICARE. Refer to Humana Military’s Web site for additional details on maternity ultrasound coverage.
If TRICARE coverage ends during pregnancy, TRICARE will not cover any remaining maternity costs unless your family qualifies for other TRICARE health coverage or has purchased the Continued Health Care Benefit Program (CHCBP).
To ensure your newborn is covered by TRICARE, see “Having a Baby or Adopting a Child” in the Life Events section.
