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01-24-04, 11:13 PM #1
The OB NAS Elimination Provides the Power of Choice
The OB NAS Elimination Provides the Power of Choice -
Make Sure Your Choice is Informed
Jan. 23, 2004
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With the exception of TRICARE beneficiaries who have had to obtain an obstetric non-availability statement (OB NAS) in the past, most beneficiaries may not have noticed recent news articles or flyers in their local military treatment facility (MTF) about the OB NAS elimination. Most beneficiaries probably think it does not apply to them. The OB NAS elimination, however, potentially affects all female Military Health System family members of child-bearing age. Understanding the OB NAS elimination is crucial for those who wish to make informed decisions about their maternity care.
"The decision to receive maternity care through a military treatment facility or civilian provider is personal. With the OB NAS elimination, TRICARE Standard users will be happy to know that they have more choices for their prenatal care, delivery, and post-natal care under TRICARE," said Dr. William Winkenwerder, Jr., assistant secretary of defense for health affairs.
Because of the new law, beginning Dec. 28, 2003, TRICARE Standard beneficiaries who have not yet had their first prenatal visit may choose a civilian provider for their care without first seeking permission from their MTF. TRICARE Prime patients will continue to go to the MTF if the services are available there. In most cases, expectant mothers with TRICARE Prime must have their prenatal care and deliver their babies in the MTF.
Because of the elimination of the OB NAS requirement, some TRICARE Prime beneficiaries who currently receive care at their MTF might be wondering if they should disenroll from TRICARE Prime and seek civilian maternity care under TRICARE Standard. In addition, some TRICARE Standard beneficiaries may be undecided about receiving maternity care at their MTF. There are four things these beneficiaries should know.
The Military Health System provides outstanding, family-centered maternity care for all patients. Military treatment facilities have professional health care providers who understand the unique needs of military families, especially in today's climate of increasing deployments. These professionals are experienced in supporting the emotional well-being of the beneficiaries whose loved ones are serving overseas.
Beneficiaries may have difficulty locating an OB provider or one who participates in TRICARE Standard and accepts the TRICARE maximum allowable charge for his or her services. It is best to check for the availability of an OB or other maternity care provider before making the decision to disenroll from Prime. Beneficiaries also should check for the availability of an authorized pediatrician for their infant before disenrolling from Prime.
With TRICARE Standard, medical services other than maternity care, are subject to out-of-pocket expenses including deductibles and co-payments. For example, if a pregnant woman or infant over three days of age suffers an injury or illness, there will be unexpected out-of-pocket expenses which could be considerable.
TRICARE Prime patients may opt to use the TRICARE Prime Point-of-Service option, which allows Prime enrollees to receive nonemergency, TRICARE-covered services from any TRICARE-authorized civilian provider without a referral from their primary care manager or authorization from a health care finder. Using the TRICARE Prime Point-of-Service option is more costly to the enrollee, and Point-of-Service charges are not subject to the catastrophic cap, which means beneficiaries could pay thousands of dollars out of pocket in a year. However, with the Point-of-Service option, beneficiaries remain enrolled in Prime.
Health care needs change during pregnancy and no decision about health care, especially at this time, should be rushed. "We encourage our beneficiaries to think about how they can get the best possible personalized, coordinated care during this special time," said Dr. Winkenwerder. Beneficiaries who are uncomfortable making this decision on their own are encouraged to speak with a TRICARE service center representative or a MTF beneficiary counseling and assistance coordinator/health benefits advisor to learn more about their options under the new law. Information about the new law also is posted on the TRICARE Web site at
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