Maternity Care Guide
Important Note
Maternity care in the US is one of the most complex and expensive healthcare situations CAF families will encounter. Most civilian inpatient maternity care has limitations under TRICARE coverage, meaning this information applies to both families with and without TRICARE access.-
Planning Your Maternity Care
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
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Understanding Costs and Coverage
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/
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Special Considerations
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)
- Meet with billing staff - Discuss payment arrangements
- Confirm self-pay status if paying out-of-pocket
- Coordinate with MSH International for potential direct billing
- Understand billing timeline - Often billed after discharge
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After Birth - Important Steps
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
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
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Emergency Situations
Complications During Delivery
- Focus on medical care: Billing can be 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
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Claims & Documentation
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
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Key Contacts
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
