Maternity Care Guide

Early Pregnancy (First Trimester)

Provider Selection:
• OB/GYN physicians: Standard for US deliveries (unlike primary care in Canada)
• Midwives: Alternative option - ensure they're licensed and have hospital privileges
• Use TRICARE network provider tool to find experienced providers
• Verify hospital privileges: Ensure your provider can deliver at your preferred hospital

Initial Steps:
• Begin prenatal care as soon as pregnancy is confirmed
• Routine prenatal care costs are generally manageable and don't require immediate MSH coordination

Mid-Pregnancy Planning

When to Contact MSH International:
Once delivery plans are established (hospital selection, delivery method), contact MSH International at 1-833-774-2700 to:
• Discuss potential direct payment arrangements
• Understand required documentation
• Clarify any coverage limitations
• Plan claim submission process

Expected Expenses

• Hospital delivery: $50,000-$70,000 USD (highly variable)
• Prenatal care: $3,000-$6,000 for full pregnancy
• Complications: Can significantly increase costs

Financial Planning

Given high costs, strongly consider requesting a medical advance early in pregnancy:
• Pregnancy advances: Up to 9 months for repayment
• Form 7000-1 required
• Email to: CDLSW-MedicalAdmin-ELFCW-AdminMedical@forces.gc.ca
• Cost estimates: Required for advance approval

PSHCP Comprehensive Coverage:

• Full details at: pshcp.ca/coverage/comprehensive-coverage/
• Exclusions: pshcp.ca/benefits/general-exclusions-and-limitations/
• Maximum benefits: pshcp.ca/benefits/maximum-eligible-expenses/

Nurse Anesthetists

• Common in US deliveries: Often provide epidurals and anesthesia services
• Not covered by PSHCP: This profession isn't recognized in Canada
• Alternative coverage: Claim through Foreign Service Directives (FSDs)
• Submit to: CFHS Det Washington team via CDLSW-MedicalAdmin-ELFCW-AdminMedical@forces.gc.ca

Hospital Coordination (Before Delivery)

1. Meet with billing staff - Discuss payment arrangements
2. Confirm self-pay status if paying out-of-pocket
3. Coordinate with MSH International for potential direct billing
4. Understand billing timeline - Often billed after discharge

Immediate Actions

✅ Obtain US birth certificate
✅ Add baby to PSHCP coverage immediately
✅ Update TRICARE if applicable
✅ Notify Orderly Room with Certificate of Live Birth

Documentation & Citizenship

✅ Apply for US passport
✅ Apply for Canadian citizenship (CIT 0001E)
✅ Apply for Canadian passport (special/standard)
✅ Update Family Care Plan
✅ Update Emergency Care Plan with MFS(US)

Newborn Coverage

• Immediate PSHCP coverage: Baby automatically covered from birth
• Add to coverage: Must be added to your PSHCP profile
• Back-dated coverage: Claims can be submitted retroactively
• NICU care: Separate bills if admitted - contact MSH immediately

Complications During Delivery

• Focus on medical care - billing addressed afterward
• Emergency C-sections: Fully covered emergency procedures
• Extended NICU stays: Contact MSH as soon as possible for coordination
• Multiple provider bills: Emergency situations often involve multiple specialists

For Claims - Keep Everything!

✅ Keep all detailed invoices and receipts
✅ Ensure bills include ICD-10 and CPT codes
✅ Submit nurse anesthetist costs to CFHS Det Washington
✅ Submit all other costs to MSH International
✅ Maintain copies of all medical records

MSH International
1-833-774-2700
For coverage coordination and claims

CF H Svcs HQ Det Washington
CDLSW-MedicalAdmin-ELFCW-AdminMedical@forces.gc.ca
For advances and FSD claims