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Maternity Services
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:
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Estimating gestational age
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Evaluating fetal growth
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Conducting a biophysical evaluation for fetal well-being
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Evaluating a suspected ectopic pregnancy
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Defining the cause of vaginal bleeding
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Diagnosing or evaluating multiple gestations
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Confirming cardiac activity
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Evaluating maternal pelvic masses or uterine abnormalities
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Evaluating suspected hydatidiform mole
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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 TRICARE Health Matters: Issue 6:2006 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.
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