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12-05-2012 at 1:02 PM
badenton
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Tricare and gender scan

I'm 15 weeks right now and living in Texas with a doctors appointment next week. I've been reading about both Tricare and what people are saying. Some say that they could not get a gender scan and others are saying that they did. From what I read there is no way to even get another ultrasound without medical necessity and so far my pregnancy is completely normal. My husband and I really want to know the gender because we are waiting until we know the gender to announce our little bundle of joy to our families that live far away from us. Anyone have experience with this kind of issue with Tricare and Gender scans? Any help would be greatly appreciated.
 
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12-05-2012 at 1:40 PM
AshleyM198...
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A normal healthy pregnancy will have 3 ultrasounds, 1 to confirm pregnancy, 1 at 20 weeks to find out gender, then one later on to make sure baby is good and comfy, generally late in the 3rd trimester! 

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12-05-2012 at 2:13 PM
Igoo0304
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Tricare does not cover sex scans, or scans only for the purpose of determining sex, because they are unnecessary. Tricare does cover the 20 week anatomy scan. This is when most people learn the sex of the baby. Tricare only covers necessary scans. These usually include a dating scan, an anatomy scan, any follow-ups that may need, scans for those who need extra monitoring for whatever purpose, and possibly a scan for placement toward the end of pregnancy.
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12-05-2012 at 3:06 PM
meltoine
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AshleyM1985:
A normal healthy pregnancy will have 3 ultrasounds, 1 to confirm pregnancy, 1 at 20 weeks to find out gender, then one later on to make sure baby is good and comfy, generally late in the 3rd trimester! 

Um, no.

The standard of care as per ACOG is 1 ultrasound to measure ALL fetal anatomy. If baby cooperates, it's possible to find out the sex at the same time.

If you are not sure of when you conceived, your doctor may do an early ultrasound to estimate your fetus's age. This is not to confirm pregnancy. Pee sticks do that just fine.

In your Tricare brochure you will find a list of reasons Tricare will cover ultrasounds.  "to make sure baby is comfy!" is not one of them. The two I listed are.  
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12-05-2012 at 3:11 PM
Bacon+lett...
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meltoine:

AshleyM1985:
A normal healthy pregnancy will have 3 ultrasounds, 1 to confirm pregnancy, 1 at 20 weeks to find out gender, then one later on to make sure baby is good and comfy, generally late in the 3rd trimester! 

Um, no.

The standard of care as per ACOG is 1 ultrasound to measure ALL fetal anatomy. If baby cooperates, it's possible to find out the sex at the same time.

If you are not sure of when you conceived, your doctor may do an early ultrasound to estimate your fetus's age. This is not to confirm pregnancy. Pee sticks do that just fine.

In your Tricare brochure you will find a list of reasons Tricare will cover ultrasounds.  "to make sure baby is comfy!" is not one of them. The two I listed are.  

Yes

Tricare will only cover what is medically necessary.

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12-05-2012 at 4:11 PM
kristinB60...
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I have had 3 ultrasounds and heard baby's heartbeat twice but then again my doctor is pretty awesome.  We have a gender ultrasound at 20 weeks which seems to be pretty standard in my area (DC Metro) but we do have to go to Bethesda to have that done and they were very adamant about waiting until 20 weeks to do it.  They also said if Bethesda couldn't get us in during that time frame then they would send us to someone out in town.  Anyways ask your OB or call Tricare and good luck!  We are 16 weeks now and can't wait to find out our baby's gender right after the new year!
 
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12-05-2012 at 4:35 PM
Igoo0304
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kristinB602:
I have had 3 ultrasounds and heard baby's heartbeat twice but then again my doctor is pretty awesome.  We have a gender ultrasound at 20 weeks which seems to be pretty standard in my area (DC Metro) but we do have to go to Bethesda to have that done and they were very adamant about waiting until 20 weeks to do it.  They also said if Bethesda couldn't get us in during that time frame then they would send us to someone out in town.  Anyways ask your OB or call Tricare and good luck!  We are 16 weeks now and can't wait to find out our baby's gender right after the new year!

Once again, it's an anatomy scan. If you get to learn your baby's sex, that's a bonus. It won't be the tech's priority. The number of ultrasounds also depends largely on your doctor's coding of the scan for tricare.
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12-05-2012 at 4:48 PM
MrsBalletS...
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At the very least, Tricare will approve one ultrasound around 20 weeks.  Yes, you are likely to find out the gender at this ultrasound, but that it is not the overall purpose of the ultrasound.  It will be (or should be) coded as "medically necessary" just to make sure your baby is growing and developing correctly.  I was able to have 2 covered ultrasounds with both of my children. 
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12-05-2012 at 6:30 PM
PatsyGK21
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I've had 6 u/s, but im highrisk, so that might have something to do with it. If you get a nice tech at your 20 week u/s, (from what I gather, this is a u/s done to measure baby, at least that was the case for me) they will tell you. They will not give you one just becasue you want to find out what you're having. If you want to find out early, there are Fetal imaging places that will do it, they are like the 3D 4D imagaing places. I warn you though, they are pricey.
 
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12-05-2012 at 7:48 PM
crogers19
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With DS I had a scan at 8 wks because she could not determine growth at that point (tilted ute). I had my anatomy scan at 18 wks during which we found out the gender. I also had one at 36 wks because I was diagnosed with pre E and they wanted to make sure the placenta wasn't abnormal. All were medically necessary and coded properly so I didnt have to pay a dime.

At 28 wks I payed out of pocket to a local imaging center to have a 4d done. it was about 150 dollars and worth every penny! 
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12-06-2012 at 1:59 AM
tlalli7106
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Igoo0304:

kristinB602:
I have had 3 ultrasounds and heard baby's heartbeat twice but then again my doctor is pretty awesome.  We have a gender ultrasound at 20 weeks which seems to be pretty standard in my area (DC Metro) but we do have to go to Bethesda to have that done and they were very adamant about waiting until 20 weeks to do it.  They also said if Bethesda couldn't get us in during that time frame then they would send us to someone out in town.  Anyways ask your OB or call Tricare and good luck!  We are 16 weeks now and can't wait to find out our baby's gender right after the new year!

Once again, it's an anatomy scan. If you get to learn your baby's sex, that's a bonus. It won't be the tech's priority. The number of ultrasounds also depends largely on your doctor's coding of the scan for tricare.

 

 

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12-06-2012 at 5:03 AM
animalcrck...
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There is no medically necessary thing as a "gender scan".  You will schedule an appointment for your anatomy scan anywhere from 18-22 weeks.  At this point, if baby cooperates, you may get to find out if you are having a boy or girl.  

If you so choose, you can go pay out of pocket in a strip mall somewhere and find out sooner.   
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12-06-2012 at 12:08 PM
jenniferdb...
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The 20 week anatomy scan is forever long. While the official word is that Tricare does not deem a gender scan medically necessary - the tech who is doing the scan is likely a civilian employee of the hospital and is more understanding and sensitive. Our tech asked if we wanted to know and we said yes, she went to look but baby didn't want to show. The tech went back several times to check things out and told us we were having a girl. Of all the military wives I have known everyone has found out what they're having.
 
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12-06-2012 at 12:41 PM
Inkogneeto...
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meltoine:

AshleyM1985:
A normal healthy pregnancy will have 3 ultrasounds, 1 to confirm pregnancy, 1 at 20 weeks to find out gender, then one later on to make sure baby is good and comfy, generally late in the 3rd trimester! 

Um, no.

The standard of care as per ACOG is 1 ultrasound to measure ALL fetal anatomy. If baby cooperates, it's possible to find out the sex at the same time.

If you are not sure of when you conceived, your doctor may do an early ultrasound to estimate your fetus's age. This is not to confirm pregnancy. Pee sticks do that just fine.

In your Tricare brochure you will find a list of reasons Tricare will cover ultrasounds.  "to make sure baby is comfy!" is not one of them. The two I listed are.  

I had 3 ultrasounds.  One to confirm how far along I was since I had no idea when I conceived.  Then the anatomy scan at about 20 weeks.  Then I had a 3rd one when I was near my due date to make sure there was enough fluid, etc.  I think that's the one she's referring to.

So yes, they will do a 3rd one late in the third trimester very close to or if you go past your due date to make sure there is no medical reason to induce.  Or "to make sure baby is comfy!" if that's how you want to phrase it.

All three of mine were covered by Tricare.  But they will not cover an ultrasound scheduled specifically to find out the gender because it's not medically necessary.
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12-06-2012 at 1:47 PM
meltoine
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Inkogneetoh:
meltoine:

AshleyM1985:
A normal healthy pregnancy will have 3 ultrasounds, 1 to confirm pregnancy, 1 at 20 weeks to find out gender, then one later on to make sure baby is good and comfy, generally late in the 3rd trimester! 

Um, no.

The standard of care as per ACOG is 1 ultrasound to measure ALL fetal anatomy. If baby cooperates, it's possible to find out the sex at the same time.

If you are not sure of when you conceived, your doctor may do an early ultrasound to estimate your fetus's age. This is not to confirm pregnancy. Pee sticks do that just fine.

In your Tricare brochure you will find a list of reasons Tricare will cover ultrasounds.  "to make sure baby is comfy!" is not one of them. The two I listed are.  

I had 3 ultrasounds.  One to confirm how far along I was since I had no idea when I conceived.  Then the anatomy scan at about 20 weeks.  Then I had a 3rd one when I was near my due date to make sure there was enough fluid, etc.  I think that's the one she's referring to.

So yes, they will do a 3rd one late in the third trimester very close to or if you go past your due date to make sure there is no medical reason to induce.  Or "to make sure baby is comfy!" if that's how you want to phrase it.

All three of mine were covered by Tricare.  But they will not cover an ultrasound scheduled specifically to find out the gender because it's not medically necessary.

I had five ultrasounds with my first pregnancy, all covered. But just because you or I did, doesn't mean that's normal or what anyone else should expect. I simply told her what Tricare covers, which is what she asked.  
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12-06-2012 at 4:10 PM
jeffsteph1...
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When I was pregnant I went to a local technical college at 16 weeks and they told me what I was having before my OB at the military hospital. Our doc was clear that we would only get ultrasounds that were medically necessary. Tricare stinks like that!
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12-06-2012 at 10:10 PM
Inkogneeto...
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I was agreeing with you and clarifying what the poster you quoted said. Sorry if it came across the opposite but I can see how it did.

ETA: Meant to quote meltoine. Damn mobile bump.
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12-07-2012 at 12:44 PM
Bacon+lett...
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jeffsteph1207:
When I was pregnant I went to a local technical college at 16 weeks and they told me what I was having before my OB at the military hospital. Our doc was clear that we would only get ultrasounds that were medically necessary. Tricare stinks like that!


It's not just tricare, my civilian insurance has the same policy. They don't want people just going to get ultrasounds all willy nilly. I just got a bill for mine I had at 10 weeks because of an absent heartbeat and its was 700 for a five min ultrasound to make sure baby was ok. Why would they want to she'll out more than necessary?
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12-07-2012 at 10:10 PM
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Our base gives the 20 week u/s to make sure that the baby is forming properly.  During that scan the tech asks if you would like to know what the baby is.   They don't do an u/s specifically for the purpose of finding out the sex of the baby, but they will tell you if they are able to when they are in the process of the 20 week u/s.
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12-10-2012 at 2:12 AM
saturdayni...
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I had the same question come up when my 20wk u/s was scheduled. This scan isn't just to find out gender, it is an important anatomy scan and Tricare does cover it, it's up to your doctor to code it correctly, but should not be a problem. Calling Tricare didn't help, I talked to 4 people that all told me different things, but in the long run it wasn't an issue.

for my first two I had a different primary insurance, so I wasn't sure what Tricare actually covered. This time around I was nervous with the term "medically necessary" but that's more determined by your ob. I had a scan around 5weeks for dating, nt test/scan at 13 weeks, 20wk anatomy scan/gender, and then a few weeks ago had a scan to measure baby to see if I could have a VBAC (not sure how they covered that one, but they did), and I'm sure ill be having at least 1 more for size and position of baby by the time I give birth... All have been covered without issue. I do not see a doctor on base as we are stationed at a small MSU without a base, so not sure if that makes a difference. 
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12-11-2012 at 6:46 AM
anastasiac...
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I was told I would only get one ultrasound for an anatomy scan.  They will tell you the sex at that scan if the baby is cooperating. I ended up getting a first trimester ultrasound to date the pregnancy since I had 2 periods the month I conceived and another in the 3rd trimester done super quick with my doctor bc I basically begged him and he was really cool.  He showed me my guys little face and that was it.

Tricare will cover as many ultrasounds as are medically needed.  So if you are having complications or a high risk pregnancy you will receive more.  My sister in law's daughter had liver calcifications at her anatomy scan and after that she received an ultrasound every two weeks to check their progress.  You will get one in the first trimester if you do not know the date of your last period or if the heartbeat is too hard to find via doppler at your first visit to make sure everything is fine and on track.
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12-15-2012 at 2:15 AM
kjfox10
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We did an elective ultrasound at 15 weeks to find out what we were having. We didn't go through tricare or anything like that. It cost us $25 :)
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12-22-2012 at 10:57 PM
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An anatomy scan is very important, and you need to have one between 18-22 weeks,  IT IS NOT A GENDER SCAN!  but people normally find out the sex. 

If you had an ultra sound before that it was for something else (dating pregnancy is very common,  and I think its the NT test they do one for also)  that doesn't count as your "one" U/S.

I have had 4 U/S so far and I'm only 21 weeks, It might even be 5 actually.  If your doctor thinks you need one then you will get one, paid for.

Personally, I don't care about the sex I just want a healthy baby.  And I was way Happier to find out my baby had a healthy heart, and 2 kidneys, then find out the sex. Thats what the anatomy U/S is for.
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12-25-2012 at 5:42 PM
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I was told by my MD not to call it a "gender scan" because the 20 week U/S is to "check the well being of the child" and not gender... But if they can tell the gender, then they will tell you. Which she said they try very hard to tell, but can't guarantee it. I found a "for fun" private U/S place that will do the 3D an 4D pics etc. for 70. Hopefully if your MD can't tell you, then you will be able to find a place that can help you.
 
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