Military families have been utilizing support networks for childbirth and the postpartum period for years. Now, certified non-medical labor doulas, certified lactation consultants, and certified lactation counselors will be covered by TRICARE.
The TRICARE Childbirth and Breastfeeding Support Demonstration (CBSD) will cover TRICARE Prime and TRICARE Select enrollees. This program will run from January 1, 2022, to December 31, 2026, and will include overseas locations on January 1, 2025. It will not cover those enrolled under TRICARE for Life, US Family Health Plan, or the Continued Health Care Benefit Program.
For those enrolled in TRICARE Prime, a referral will need to be placed by the primary care manager if you see a non-network provider, otherwise, no referral is needed.
To qualify for childbirth support and certified labor doulas, you must be enrolled in TRICARE Prime or TRICARE Select, be at least 20 weeks pregnant, and see a TRICARE-authorized provider for the birth. If giving birth in a military hospital or clinic, the doula would not be part of the CBSD plan. Giving birth at home with a certified midwife will be covered as long as the midwife is certified and a TRICARE-authorized provider. Up to six visits with a labor doula will be covered as long as the doulas are within the network or if they are non-network doulas they must meet CBSD qualifications.
To qualify for lactation counselors or consultants and breastfeeding support, you must be enrolled in TRICARE Prime or TRICARE Select, be at least 27 weeks pregnant and receive services from an Independent Board Certified Lactation Consultant (IBCLC) or Certified Lactation Counselors during an inpatient maternity stay, follow-up outpatient visit or a well-child care visit. Up to six (6) sessions are covered in outpatient sessions if provided through a TRICARE authorized provider or clinic and is billed as a preventative service.
Lactation counselors are non-medical professionals who provide counseling on breastfeeding and support to parents in either individual or group sessions.
Lactation consultants are non-medical professions who provide care in all breastfeeding support including breastfeeding complications. A lactation consultant can also provide care through a group session.
This coverage would be covered without cost shares, deductibles or copayments as long as the provider is within the TRICARE network.
There is no need to enroll in the CBSD, as a TRICARE Prime or Select member, any claims submitted will be covered under the CBSD.
