TRICARE Pregnancy & Maternity Coverage Guide (2026) | TRICARE.com

*Note: TRICARE.com is an independent reference site and is not the official TRICARE program or the Defense Health Agency (DHA). For official policy, visit TRICARE.mil.*

## Is it covered? Yes, TRICARE covers all medically necessary maternity care, including prenatal care, delivery, and postnatal care. Coverage includes services provided by obstetricians, certified nurse-midwives, and authorized birthing centers.

## What TRICARE covers TRICARE’s maternity benefit is comprehensive, covering the journey from conception through six weeks postpartum. According to the TRICARE Policy Manual, covered services include:

* **Prenatal Care:** Routine office visits, ultrasounds (when medically necessary), and screenings for gestational diabetes or Group B Strep. * **Delivery Services:** Hospitalization for labor and delivery, or services at a TRICARE-authorized birthing center. This includes anesthesia (epidurals) and Cesarean sections if required. * **Postpartum Care:** At least two follow-up visits after delivery to monitor the mother's recovery. * **Newborn Care:** Initial hospital exams, circumcision (if performed before hospital discharge), and neonatal intensive care (NICU) if required. * **Breastfeeding Support:** TRICARE covers the cost of one manual or electric breast pump per birth event and up to six sessions of lactation counseling. * **Testing:** Genetic testing (such as amniocentesis or CVS) is covered if the mother is over 35 or has specific risk factors. Non-invasive prenatal screening (NIPS) is also covered for high-risk and average-risk pregnancies.

**What is NOT covered:** * Elective ultrasounds (3D/4D "keepsake" photos). * Doula services (unless part of the TRICARE Childbirth and Breastfeeding Support Demonstration). * Private hospital rooms (unless medically necessary). * Cord blood banking (unless medically necessary for a specific sibling condition).

## Costs Maternity costs vary significantly based on your status (Active Duty vs. Retiree) and your specific plan. For **2026**, the following general rates apply:

* **TRICARE Prime (Active Duty/Active Duty Family):** $0 out-of-pocket for all covered maternity services. * **TRICARE Select (Active Duty Family):** No copays for prenatal or postnatal office visits if using a network provider. However, there is a per-day or flat institutional fee for the actual hospital stay (varies by Group A vs. Group B; check TRICARE.mil for 2026 daily rates). * **TRICARE Prime (Retirees/Families):** Copays apply for specialist visits and a per-day charge for hospital stays. * **TRICARE Select (Retirees/Families):** Cost-shares are typically 20-25% of the TRICARE allowable charge after the deductible is met. * **TRICARE Reserve Select:** Subject to deductibles and cost-shares.

## Pre-authorization & referrals * **TRICARE Prime:** You require a referral from your Primary Care Manager (PCM) for obstetric care. Most PCMs will provide a "blanket" referral to an OB/GYN for the duration of the pregnancy. * **TRICARE Select:** No referral is required; you can manage your own care and visit any TRICARE-authorized provider. * **Prior Authorization:** Generally not required for routine vaginal deliveries. However, authorization may be required for certain genetic tests, surgical interventions, or if you are seeking care at a non-network facility.

## Where to get care Where you receive care depends on your region and plan:

1. **Military Hospitals/Clinics:** Active duty members and Prime enrollees often receive care at Military Treatment Facilities (MTFs) if space is available. 2. **East Region:** Managed by **Humana Military**. Use their online provider directory to find network OB/GYNs. 3. **West Region:** Managed by **TriWest Healthcare Alliance**. Use the TriWest provider portal to find in-network maternity specialists. 4. **Overseas:** Managed by **International SOS**.

## Sources * **TRICARE Policy Manual:** Section 7.1 (Maternity Care): [tricare.mil/Benefits/Coverage/MaternityCare](https://tricare.mil/Benefits/Coverage/MaternityCare) * **Defense Health Agency (DHA):** Maternity Care Brochure * **TRICARE.mil Costs:** [tricare.mil/costs](https://tricare.mil/costs) * **TriWest Healthcare Alliance:** West Region Provider Search [triwest.com]