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Thread: Tricare

  1. #1
    Join Date
    Dec 2009
    Location
    Kansas
    Posts
    38

    Question Tricare

    I have been researching my primary insurance plan (BCBSKC) and it is all a blur so now I need to look into my secondary insurance plan.

    We have Tricare reserve select in the west region. I have been looking for info because I have heard people saying that Tricare will not cover surrogacy if it is comped. The only thing online from a Tricare site that I can find state the following:

    Surrogacy – Services and supplies associated with maternity care, including antepartum care, childbirth, postpartum care and complications of pregnancy, may be cost-shared where the surrogate mother is a TRICARE beneficiary. TRICARE excludes costs associated with surrogacy when the surrogate is not a TRICARE beneficiary.

    Note: When a TRICARE beneficiary is acting as a surrogate and has entered into a contractual agreement with the adoptive parents, a contractual agreement will be considered primary coverage. Any undesignated amount or amount designated for medical expenses under the contract must be exhausted before TRICARE will cost share otherwise covered benefits for the TRICARE beneficiary.

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    I am a tricare beneficiary so the surrogacy would be covered but confused about the note section. Does that mean that the contact has to state the the IP's will pay out of pocket for a certain amount before Tricare will kick in?

    What if we don't list an amount as out of pocket? Does that mean that Tricare will have to kick in right away?

    Any help would be greatly appreciated.

    Thanks,
    kansasbridget

  2. #2
    Join Date
    Feb 2008
    Location
    Washington, DC
    Posts
    325

    Default

    Oh dear.... welcome to the confusing world of health insurance.

    So, first, are you sure that your primary policy excludes surrogacy? When you are looking at a "regular" health insurance policy, it will never say it covers surrogacy. The question is whether it says it excludes surrogacy under the maternity benefits section. If it does not, then some IPs are willing to move forward. Others will move forward but take out one of the policies that are written specifically for IPs so that if a surrogate's health insurance is rejected on the ground of surrogacy, the other policy kicks in. That is why these other policies are often referred to as the "sleep at night" policies.

    Second, Tricare is so tricky that I would not hazard an opinion. I have heard that they are doing "take-backs" after the fact if they think that the costs are covered elsewhere -- whether by contract, other insurance or whatever. So, you need to know what your primary insurance covers. How your contract is written is critical. And, as an attorney, I always recommend to iPs that they take out the 'sleep at night' policy if they are relying on Tricare (these other policies, like New Life's back-up policy, are not 'health insurance' and therefore will not undermine Tricare's coverage) -- just because Tricare's coverage is so difficult to figure out.

    Sorry I cannot be more specific. I would LOVE to be able to be clearer!

    Good luck,
    Diane

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