Spouses Speak: Why Pregnancy Must Be a Qualifying Life Event

Pregnancy is a life-changing event, but for military families, it comes with added uncertainty and limited choices. Navigating the military health system is already complex, and the unique military lifestyle can disrupt essential prenatal care. These challenges create unnecessary barriers that can put both mother and baby at risk. 

Military spouses and expectant mothers face more hurdles than they should. Their stories of waitlists, denials, and frustration highlight a system that needs change. To better support military families, Congress must make pregnancy a Qualifying Life Event (QLE) for TRICARE beneficiaries. 

Spouses Are Tired of the Runaround

Military families can switch between TRICARE Prime and Select health care plans during open enrollment or a qualifying life event. On Prime, families are assigned a Primary Care provider at their local Military Treatment Facility (MTF) and must go that route to get referrals for specialty care. With Select, military families seek care without referrals and can choose network providers. Military families cannot switch plans unless a QLE occurs—such as a move, marriage, divorce, birth, or adoption. 

Navy spouse and certified doula, Kaitlyn Morrison, has provided an ear for numerous military families facing challenges during their pregnancy journey. 

“Many of my clients have wanted to switch to Select or Prime to have a different birth experience that was more aligned with their wishes and values, but were not allowed to because it wasn’t open season and they didn’t have a qualifying life event,” said Kaitlyn. “Families feel trapped. It doesn’t make sense that the birth of a child is considered a QLE, but pregnancy is not.” 

Navy spouse Victoria Cummings, currently pregnant and due in a few weeks, shares her experience with the stress of limited care options. 

“It was an absolute nightmare. Not only did I have to deal with finding care, but there was also the big switch from Health Net to TriWest,” she recalled. “I spent hours on the phone trying to get help and being told different things with each phone call. I got so frustrated and scared because weeks passed without care for my pregnancy that I started crying and freaking out to the representative I was talking with.” 

Military families deserve better than this. 

“If they would allow families to switch plans during pregnancy, it would have given me the opportunity to find care sooner, and there would be no lapse in monitoring my son and I,” Victoria said. “I would have been able to go to the clinic I wanted to go to and not be limited in my choices.” 

Why Pregnancy Must Be a Qualifying Life Event

NMFA’s advocacy efforts to make this change for military families have been important because of stories like Kaitlyn and Victoria’s. 

We know some MTFs are amazing, but others face chronic understaffing and long wait times. TRICARE Prime families often don’t discover this until after they’re pregnant—when it’s too late to switch plans. 

That was the case for La’a Hensley, a new Army spouse and first-time TRICARE benefit holder. For two years, the Hensley family was seen by their local MTF while trying to conceive. 

“When we got a positive test, I was also told that I was a high-risk pregnancy.” La’a shared. “This meant multiple appointments, sometimes weekly.” 

La’a and her husband delved into creating a pregnancy plan and encountered the differences between Prime and Select. 

“I wanted to have a doula in the labor and delivery room with me, but with our MTF, it comes at a cost. If we could have switched to Select, a doula would be covered. So not being able to make choices to switch at any time just doesn’t sit right with me.” 

Kaitlyn knows exactly how La’a feels. As a doula, she wholeheartedly believes mothers should have the ability to choose a birth setting and provider that aligns with their needs. 

“It would allow them to feel more in control of their care and, ultimately, their birth experience, which could lessen birth trauma and unnecessary interventions.” 

It’s Time for Change 

We’ve heard enough heartbreaking stories from military spouses struggling to access the care they deserve during pregnancy. Military families have sacrificed enough—having quality prenatal care shouldn’t be another battle. The solution is clear: Congress must make pregnancy a Qualifying Life Event (QLE) for TRICARE beneficiaries. 

Share your story, and together, we can push for the change military families need. 

By: Angela Sablan Tenorio, Content Manager