What You Need to Know About TRICARE’s Banked Donor Milk Policy — From The Start, Postpartum Doula

All right. We have covered the cost of BDM. But, we do not cover all the costs associated with this benefit. Shipping. Let’s talk about shipping.

I’ll be honest here – it’s not something I feel confident about. Talking about shipping is getting the insurance codes and, well, those are not my jam! The TRM says this in paragraph 4.6 about shipping: “Reimbursement for HCPCS code T2101 includes the processing, storage, and distribution of BDM. Separate charges for shipping or other services are not separately payable.” So, is shipping part of “distribution”? If so, it appears to be covered under the code. If not, and if it is a separate service (which I believe most are), it is not a covered service. So, to adequately prepare you for this, I am strongly under the impression that this BDM shipment is NOT a covered service and the costs shipping will be paid out of pocket (although, check with your accountant because you can, I say again, maybe, they can be claimed as medical expenses). I certainly don’t know the answer to this so if any of you out there know the answer, or when you do, please let me know!

Information from TRICARE Claims

Now that you know all this (thanks for reading, by the way!), I want to share a little bit from my conversation with the amazing Amy.

As I mentioned above, the BDM policy is currently in effect, although it has not yet been implemented. That means, between now and 20 May 2019, we are all in a state of limbo. Be careful using the BDM policy. You can still use it because it is an effective, covered service so, with the proper paperwork and documentation, you should receive reimbursement. As of March 21, 2019, the TRICARE Claims section has not received guidance or information on how to process these claims and how to administer this new coverage, so please proceed with caution. If you need a BDM now, you will be late between the effective date and the implementation date.

My phone call with Amy clarified this a bit. He said you can still submit your claim, no matter what. It may be rejected, but as long as you submit it, that record will be created which should open the door for future reimbursement. You just want to track the claim and when 20 May 2019 comes around, make sure you follow up with TRICARE about the claim.

Phew. There it is. My research, phone calls, and related brain-dump about the new policy. Those who have an inquisitive mind, surely you have a question! Feel free to ask me questions and I’ll do my best to clarify, find you regulatory answers, or give you the TRICARE phone number!

Now, how the magic happens. Especially how the magic happens in California.

Breast Milk Bank

As part of writing this article, I wanted to include details for how TRICARE families in Southern California can take advantage of this new benefit. So, I did what TPM said and searched the HMBANA website for my nearest bank. To my surprise, the nearest bank is Breast Milk Bank in my hometown of San Jose, CA (about a 6 hour drive). So, I started contacting Pauline Sakamoto, the executive director, and, after a bit of phone tag, we connected for a good conversation about this long overdue change in TRICARE coverage.

Pauline is really amazing. She has been in the world of lactation and breastmilk for many years. Decades really. She has helped thousands of families on their breastfeeding journey and is just a ray of sunshine for these families. He explained many things to me, including the logistics of Mother’s Milk Bank, their pricing, and their operations. I was humbled when she repeatedly said how much the Mother’s Milk Bank loves their military moms. She said that over the years, she has received hundreds of ounces of donated breast milk from military mothers and is forever grateful for their efforts and reliability. I can literally hear Pauline’s smile as she talks about military moms. She explained that she receives so many milk donations from military moms all over the country, but especially from our military moms in Southern California! Obviously, I was hooked!

Pauline shared some stories of military families they have had the opportunity to support over the past few years. He told some sad stories about how families needed BDM, but immediately warmed my heart when he admitted that the Mother’s Milk Bank and these families were able to work together for a plan to ensure that the BDM is young, despite the cost and lack of TRICARE coverage.

He also shared that he sent milk from the Mother’s Milk Bank to support a military family in Italy. True story…he drove from San Jose to Travis Air Force Base and got this shipment of milk on a C-17 that was scheduled to fly to Italy.

So when I say he’s as excited as I am about this change in TRICARE coverage, I really mean it. He understands. He is just trying to become a TRICARE provider in the network. And now is his turn!

Receives BDM from Mother’s Milk Bank

I spoke with Pauline on Thursday, March 21, just two days after the new policy was released, and Pauline said she already had a military mom who contacted her about the policy.

Pauline describes how Mother’s Milk Bank typically does business. He told me, “Usually, a prescription is for about 24oz per day for a certain number of days, weeks, months. The best way to do this is to give about 1-1.5 weeks of amount of milk in the first shipment. Then it will take about 2 weeks of milk because sometimes family freezers can’t hold that much milk. If the prescription is for 24oz per day but the baby only takes of 8oz per day, they will work with us to keep ordering milk until the prescription runs out. Families avoid having to store milk and then throw it away.”

I asked where he was shipping, and, as you can guess from the C-17 pallet above, he said they ship anywhere and only overnight express. And they turn quickly too. Pauline said “if the prescription comes Monday through Thursday, the family will get milk the next morning.” He said that the Mother’s Milk Bank, and all HMBANA banks for that matter, have a priority list and milk distribution flows (ha, pun intended) in accordance with the priority list.

Another amazing thing about Mother’s Milk Bank is their cost. This bank can provide BDM at $3.75 per ounce, which is a very low price. Pauline says they are able to do this because of the wonderful donors who donate huge amounts of breast milk. If their volume goes down, he indicates that the price needs to go up.

You may recall from above how this process works from TRICARE’s side, but Pauline also briefly described how receiving BDM works from her side. He confirms that a family needs a prescription, their name and family member’s phone/email to confirm the address, will ask for ID (tricare information), then make arrangements to ship. It’s a very simple process and can be started almost entirely from their website: www.mothersmilk.org/receive-milk.

Donating milk to the Mother’s Milk Bank

Are you inspired by it? Looking to become a breastmilk donor? If you are interested in donating breastmilk to the Mother’s Milk Bank, first of all, God bless you. Seriously. You’re amazing even considering it. What a great gift you can give and thank you so much for thinking about it.

For those of us in Southern California, BreastfeedLA has great webpage which describes milk depots and provides information about the four main, recognized depots in our area.

The first thing you need to do is call the toll-free number (1-877-375-6645) to make sure you qualify as a donor. Then email, fax, or mail a questionnaire for you to complete about your medical history. Finally, after your forms are approved, a free, small blood test will be required for final approval. Once you are approved and cleared to be a donor, Mother’s Milk Bank will provide you with free temperature-controlled shipping to depots/facilities, as well as providing you with free milk storage bags. Seriously, once you’re approved, there’s no financial cost to your breast milk donation! Visit Mother’s Milk Bank’s donor information page for more details.

As I close this article and this research, I want to wholeheartedly thank Pauline and her staff for all the work they do for this effort. I am so happy to be connected with her and the Mother’s Milk Bank. Look for some potential future events featuring military families and Banked Donor Milk!

I was more than happy this time with the TRICARE policy. There are a few other changes I’d like to see (ahem, doula coverage!), but I’m excited to see this as a covered benefit. It may be a little rough over the next few months as TRICARE tries to adjust, but give it time and patience (and possibly repeat claim submissions) and it will happen.

I have a good feeling about it!

stay blessed,