1. You’re Expecting! Congratulations!

If you just found out that you are expecting, you likely have a number of questions going through your head: What should I do next? Where can I deliver my baby while I’m posted overseas? Who will pay for my medical care if I’m overseas? How does the new paid parental leave work under FMLA? What types of leave are available to me in addition to paid parental leave? What allowances will I keep and what will I lose? These questions will be addressed in this part of the Guide.

1.1 Onset of your pregnancy

At the very beginning of your pregnancy, schedule an appointment with your health provider. If you are posted overseas, make an appointment with the health unit or Regional Medical Officer (RMO) for guidance and arrangements regarding your prenatal care overseas. Notifying the RMO or health unit early allows them to better coordinate your prenatal care. You may wish to inform your supervisor early to permit time to plan for your upcoming prolonged absence.

Per the American Congress of Obstetricians and Gynecologists (ACOG) Guidelines, the Bureau of Medical Services (MED) recommends that every pregnant woman be offered prenatal screening for chromosomal abnormalities. The first trimester chromosomal screening should be performed between 10–13 weeks gestation. MED also recommends that pregnant women have an anatomical ultrasound at 18–20 weeks gestation. If these procedures are available at post, you must do them at post. If not, then you may choose to do them in your post’s designated medevac destination, or in the United States on a cost-construct basis. So if you choose to travel to the U.S. for the screenings the travel and per diem rate is based on either the U.S. destination rate, or the overseas medevac rate, whichever is lower.

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1.2 Where you can deliver your baby

In the United States

If you choose to return to the United States for childbirth, you may wish to consider the post-birth administrative advantages of giving birth in the DC area: it is generally easier and faster to get your baby added to your orders, to apply for and receive their passports, and to take care of travel arrangements when you are able to personally visit the offices handing these issues.

It is, of course, possible to take care of the above tasks from outside of the Washington, DC, area. Family, social support, and existing relationships with healthcare providers are important considerations in selecting where to deliver your baby.

Overseas

While MED strongly encourages all pregnant women to deliver in the United States, where standards of care are monitored and enforced, other choices are available.

MED may approve travel to other overseas locations only to a post with a level of obstetrical and neonatal care that is both adequate and higher than that available in your country of assignment. You may also choose to deliver at your current post. Please consult with your Embassy Health Unit as early as possible, as delivering at post may not be advisable. In all countries, in the course of your discussions with your health unit, you will be asked to sign an acknowledgment of the State Department policy associated with an in-country or post-to-post medevac for delivery. It is extremely important to speak to your Health Unit or RMO early. In addition to the quality of medical care, they may also consider your family situation. For example, if you or your spouse is of German origin and you have family in Germany, this may be taken into consideration to support a medevac to Germany instead of London. RMO/MP will contact Med Foreign Programs and the RMO in the city where you wish to deliver. All three would need to agree to a post to post OB medevac. 16 FAM 315.2 c.

The State Department has established medevac centers in certain cities around the world, which serve as the designated medevac destination for posts with inadequate medical facilities. The amount and types of support available to you will vary depending on whether there is a medevac center at your intended destination.

Medevac centers have dedicated resources to assist you during your medevac and are more familiar with the entire medevac process. If you choose to deliver in a city without a medevac center, the medical provider at your post should discuss your plans with the RMO where you wish to be medevaced, and that RMO must agree to your medevac before it can be authorized. You will not receive logistics support from the Embassy Health Unit, including help finding lodging, doctors, and administrative support in submitting medical claims.

You should also consider whether your child would acquire U.S. citizenship at birth if born overseas. Children born in the United States acquire U.S. citizenship automatically. Children born overseas may or may not acquire U.S. citizenship, depending on the applicable law.

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1.3 Who pays for your medical care

Payment for your outpatient prenatal care such as doctor’s appointments, blood and other laboratory tests, and ultrasounds are your responsibility, but these charges are eligible for reimbursement for amounts not covered by your primary insurance if you were posted overseas while pregnant and were hospitalized for 24 hours or more for the delivery. Therefore, you should wait to submit claims for reimbursement of outpatient prenatal care to the State Department until after your delivery. You should submit claims promptly to your primary health insurance for reimbursement and retain copies of these bills as well as your insurance company’s “Explanation of Benefits” regarding these claims.

MED recommends that you pay the full balance due after any insurance payments to your provider prior to submitting a claim for the balance to the State Department for reimbursement.

The U.S. government serves as the secondary payer for any hospitalization during your pregnancy, including delivery, if you have been posted overseas during any part of your pregnancy. This means after you have submitted a claim to your health insurance, and that company has paid what it will cover, the U.S. government pays remaining authorized expenses. Expenses not generally covered by the insurance company (such as private room, TV, telephone, etc.) will not be reimbursed.

The U.S. government does not act as the primary insurer. This means if your primary health insurance does not cover the hospitalization, or if you have no primary health insurance, the U.S. government pays nothing, and you are responsible for both inpatient and outpatient expenses.

To help cover medical costs, MED will send you a letter of authorization for hospitalization (Form DS3067), Authorization for Medical Services for Employees and/or Dependents). For overseas delivery, your health unit at post must issue the DS-3067 before you travel to your overseas delivery destination. If you are delivering in the U.S., you must contact MED immediately after arriving at your U.S. medevac destination, either by calling the OB Medevac Coordinator at 202.663.1662 or email MedForeignPrograms@state.gov. Upon notification of your arrival, MED will send a packet of information and forms that you will need while on medevac, including the DS-3067.

This authorization names the State Department as the secondary payer after insurance and includes the costs of the hospitalization and outpatient services directly related to that hospitalization for one year from the date of the first service rendered for the pregnancy. Secondary payer coverage is limited to the scope of the underlying policy and the co-pay amounts not covered by primary insurers. If your insurance denies any payment, then DOS will also deny payment. Further, deductibles are not reimbursable.

The DS-3067 is primarily designed to cover you for delivery, and any complications related to it. It provides authorization for costs related to hospitalization of your newborn post-delivery, but once your baby has been discharged it does not cover things like well-baby visits, etc. These costs should be borne by your primary health insurance, to which you should add your new baby. You should consult your own insurance for instructions on how to add your new baby. For more specific funding questions, contact MEDClaims@state.gov.

If you deliver your baby in the United States, you are responsible for submitting claims for reimbursement for allowable charges (after your primary insurance has paid their portion of the bills) to MED/CLAIMS for payment. This should include Explanation of Benefits forms (insurance documentation explaining what they have paid), proof of your payment to the provider of any balance due, an itemized invoice, and a copy of the DS-3067. This hospitalization-related outpatient care extends for the period of one year from the date of the first service submitted for payment of medical care received in the medevac location. After delivery, you may submit claims as they come in. There are two ways to submit the claim:

• Scan and attach to an email to: MEDClaims@state.gov (this is the preferred method)
• Fax: 202-663-3858

If you deliver your baby overseas, when MED issues you a DS-3067, they will also create a fund cite at either your home post or post of delivery. You should submit your claims to your insurance the same as above. When your insurance company sends the reimbursement checks, you should sign them over to the finance office at the embassy to be applied to the fund cite. If the embassy pays any amounts on your behalf which end up not covered by your insurance and not eligible for reimbursement under the DS-3067, you will need to reimburse the embassy directly.

If the overseas medevac point is to a medevac center, then the health unit at the medevac point will provide administrative assistance. You should provide the Embassy’s health unit or budget section with a copy of the DS-3067 to facilitate payment of hospital bills.

You may apply for an advance of allowable medical per diem before departure from post. Ask your post’s Financial Management Office how to apply for this advance. You will need a copy of the fiscal data cable. Advanced funding to pay costs of hospitalization is not automatic for a post to post OB medevac. However, the authorizing RMO or Medical Provider may request fiscal data for hospitalization (typical cost of giving birth at a local hospital) prior to your departure. An estimate of the up-front hospital costs should be obtained from the proposed receiving post and sent in a MED Hospitalization Request cable to MED BUD for fiscal data. Fiscal data will then be sent to your assigned post. You may make arrangements with the selected medevac post to determine if the selected medevac site would pay the hospital bills using the fiscal data and the subsequent fund cite provided to your assigned post. This arrangement is left up to you and the receiving post.

If you fail to make necessary arrangements with the selected medevac post for the hospital bills to be paid from the fund cite, and your hospital does not accept your insurance, you will have to cover the hospitalization expenses up front and be reimbursed later by your insurance carrier first, and through the DS-3067 with the State Department Medical Program as secondary payer. You can contact, Hospitalizations@state.gov, with your overseas hospitalization reimbursement questions.

Note: If you are travelling on a workday, you may use administrative leave for travel to and from your medevac location in lieu of annual leave.

If you are an employee, including Eligible Family Members on a Family Member Appointment, you must be either in an approved work arrangement or on approved leave status during medevac.

1.4 Paid Parental Leave under FMLA

Effective October 1, 2020, State Department employees who are eligible for FMLA are also eligible for paid parental leave under FMLA for the birth of a child on or after October 1, 2020. Please review 3 FAM 3530 carefully which was revised in September 2020 to incorporate the provisions of paid parental leave.

Basically, the original unpaid Family Medical Leave Act (FMLA) still exists which allows you to take up to 12 weeks of unpaid leave within a 12 calendar month period for the birth and care of your son or daughter, the care of a family member who has a serious health condition, or for your own serious health condition. A serious health condition includes incapacitation due to pregnancy, childbirth, recovery from childbirth, periods of morning sickness, and medically prescribed bed rest. This applies even if you do not (or your family member does not) receive active treatment from a health care provider during the period of incapacity, or the period of incapacity does not last more than 3 consecutive calendar days. Supervisors may not refuse leave requests filed under FMLA, as long as proper medical documentation is submitted.

You may invoke unpaid FMLA prior to the birth of a child and you may use any of the following types of leave for medical appointments or periods when you or your family member is incapacitated:

• Accrued, accumulated, or advanced annual leave;
• Accrued, accumulated, or advanced sick leave;
• Leave Without Pay (LWOP); and/or
• Donated leave received through a shared leave program (Voluntary Leave Transfer Program and Voluntary Leave Bank).

The new paid parental leave provisions under FMLA allow employees to “substitute” a maximum of 12 weeks of paid leave when a child is born. The benefit extends to both the birth and non-birth parent. However, please be aware that you are eligible for a maximum of 12 weeks paid/unpaid leave under FMLA within 12 calendar months. In other words, if you invoked unpaid FMLA before the birth of your child to cover absences due to a difficult pregnancy, for example, that period of time will be subtracted from your overall 12 week paid entitlement.

Paid parental leave expires either at the one year anniversary of the baby’s birth, or one year after the first invocation of FMLA – whichever comes first.

Examples of possible scenarios:

• Example 1: Alison had a baby on October 31, 2020. Since she did not invoke a FMLA entitlement in the last 12 months, Alison invokes FMLA on October 31 and is eligible for 12 weeks of paid parental leave.
• Example 2: Emma had a difficult pregnancy and needed 4 weeks of bed rest before the birth of her child. She didn’t have any accrued sick or annual leave, so she invoked unpaid FMLA on November 1, 2020. On December 1, she gave birth and substituted paid parental leave. Emma gets 8 weeks of paid parental leave. Her FMLA entitlement ends on October 31, 2021.
• Example 3: Marta gave birth on May 1, 2021, and used four weeks of accrued sick/annual leave. On June 1, she invoked paid parental leave and is entitled to 12 weeks. FMLA expires May 1, 2022.
• Example 4: Anika takes 6 weeks of accrued sick leave (outside FMLA) to recover from childbirth. She then invokes paid parental leave. After 12 weeks of total leave, she returns to work for a time and later uses the remaining 6 weeks of paid parental leave.
• Example 5: George used 12 weeks of paid parental leave for the adoption of his son in May 2021. His wife had a baby in December 2021, but he cannot take more paid leave until May 1, 2022. He invokes FMLA on May 1 and receives 12 weeks for the birth. FMLA expires December 5, 2022.

You must apply for paid parental leave. You can begin the process before the birth, but leave begins on the birth date. Required forms include:

• DS-1923 (FMLA application)
• DS-5154 (Work Obligation Agreement – promise to return to work for 12 weeks)
• DS-5155 (Request for Paid Parental Leave)
• Submit all forms to your supervisor for review and approval
• Once bureau director approves, HR sends DS-5155 to PAYINTAKE@state.gov
• DS-5154 is not signed by supervisor but required
• Include a copy of baby’s birth certificate (if available)

Note for Employees Assigned Overseas: As of this guide's publication, updates are in progress to FAM 3433 and 3 FAH-1 H-3431 so that Foreign Service employees on paid parental leave still receive continuous overseas service credit for home leave eligibility.

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1.4.1 “Stacking” Personal Leave and Paid Parental Leave

You may request to use annual leave or sick leave in addition to invoking paid parental leave under FMLA and, in such a case, your leave approver will exercise their normal authority. The act of requesting leave under normal procedures with the intent of using paid or unpaid FMLA leave at a later date is known as “stacking” leave, and is permitted, subject to the normal rules governing the approval of such leave. See 3 FAM 3534.3

Sick leave is a separate entitlement from FMLA. As set forth in 3 FAM 3420, employees who follow procedures for requesting sick leave and who provide required medical certification must be granted their accrued sick leave. Pregnancy and childbirth are considered qualifying medical emergencies. You may also use annual leave – subject to the approval of your supervisor.

Example: Jenny delivered a baby girl on December 1, 2020, but requested 4 weeks of accrued sick leave during her recovery period – as certified by a medical provider – instead of invoking paid parental leave under FMLA. After her recovery period, Jenny requested 2 weeks of accrued annual leave to bond with her healthy baby. After 2 weeks of annual leave, Jenny invoked paid parental leave under her FMLA entitlement for the first time in 12 months and received 12 weeks of paid parental leave. Her FMLA entitlement expires on December 1, 2021 – the first anniversary of the baby’s birth.

Sick Leave: Accrued/accumulated sick leave can be used, with appropriate medical documentation, for:

• Any period when you are incapacitated for the performance of duties by physical or mental illness, injury, pregnancy or childbirth (including periods of morning sickness, medically prescribed bedrest, and recuperation from childbirth);
• Providing care to a family member (birth parent or child) with a serious health condition;
• Taking an infant or birth parent to medical appointments (up to 104 hours);
• Providing care for a family member who is incapacitated by a medical or mental condition, or where an incapacitated family member requires psychological comfort and the family member would benefit from your care or presence (up to 104 hours).

Note: Accrued sick leave is not designed for care of or bonding with a healthy child. This applies to the non-birth parent as well.

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1.4.2 Advanced Sick Leave

If you run out of accrued sick leave, you can request up to 240 hours (30 work days; approximately 6 weeks) of advanced sick leave for a serious medical condition of your own or of a family member (including pregnancy and childbirth), or when you personally are incapacitated for the performance of your duties by pregnancy or childbirth. You can also request up to 104 hours (13 work days; approximately 2.5 weeks) of advanced sick leave to provide care for a family member who is incapacitated by a medical or mental condition, or to attend to a family member receiving medical examination or treatment. Supervisory approval is required. Medical documentation is generally required for any sick leave period greater than three days.

Advanced sick leave is paid back as you accrue it. Since you earn sick leave at a rate of 4 hours per pay period, 240 hours would take 60 pay periods to repay—almost 2.5 years if you do not use additional sick leave during that time. Shared leave (see section 1.4.7) can be used to reduce advanced sick leave balances.

Important: If you leave the Department of State while carrying a negative leave balance, you will be required to repay the deficit.

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1.4.3 Accrued Annual Leave

You may request use of your accrued/accumulated annual leave, which would have to be approved by your supervisor unless you invoke the FMLA. Supervisors are encouraged to grant annual leave for purposes related to pregnancy and childbirth to the maximum extent practicable consistent with the mission’s needs. The substitution of accrued/accumulated annual leave for unpaid leave under the FMLA cannot be denied for employees who have invoked FMLA.

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1.4.4 Advanced Annual Leave

You may request advanced annual leave, which is the number of hours you would accrue through the end of the current leave year. This means that those giving birth earlier in the year may have more advanced annual leave available than those who deliver later in the year. Approval of advanced annual leave is at the discretion of your supervisor.

Note: If you leave the Department of State while carrying a negative leave balance, you will be required to repay the deficit.

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1.4.5 Intermittent Paid Parental Leave

Paid parental leave under FMLA may be taken intermittently subject to the mutual agreement of the employee and the supervisor in accordance with 3 FAM 3534.2 in 3 FAM 3430. The desire to use paid parental leave intermittently is noted on the DS-5155. A thirty (30) day notice is required whenever possible; otherwise notice is required as soon as possible.

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1.4.6 Shared Leave

There are two types of shared leave programs:

1. Voluntary Leave Transfer Program (VLTP): Allows donations of annual leave from State Department employees, or from family members or in some cases friends at other agencies, directly to you for approved medical emergencies.
2. Voluntary Leave Bank Program (VLBP): Distributes pooled annual leave to eligible members of the leave bank based on set criteria.

If you will exhaust all types of accrued leave and face 24+ hours of unpaid absence due to a medical emergency (including pregnancy/childbirth), you may apply for one or both programs. Your Earnings and Leave Statement (ELS) is required with the application.

Consult your post’s HR Office before medevac. If applying to both programs, VLBP will be reviewed first.

To apply for VLTP:

1. Complete form DS-0630
2. Complete the Leave Application Employee Coversheet
3. Include medevac cable or medical certification with required details
4. Include most recent Earnings and Leave Statement
5. Submit application to VLB-VLTPrograms@state.gov

To apply for VLBP:

1. Ensure timing eligibility (during open season, within 60 days of EOD or return from extended absence)
2. Complete form DS-0630 in eForms
3. Provide WH-380-E/F or medical certification as described
4. Complete DS-7100 or Form 71
5. Include most recent Earnings and Leave Statement
6. Complete Leave Accounting Worksheet (required for retroactive requests and closing)
7. Submit to VLB-VLTPrograms@state.gov

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1.4.7 Telework

Employees who arrange telework from their medevac location (for post or Washington) must create a telework agreement aligned with Department policies. Bureaus are encouraged to support flexible arrangements.

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1.4.8 Temporary Work

You may arrange short-term full- or part-time work during medevac. Contact your regional bureau EX or post. Explore Agility @ State for opportunities up to 90 days.

Consular officers delivering in the U.S. may seek temporary duty at Passport Agencies with help from CA/EX (ConsularBidders@state.gov) or their CDO. If delivering overseas, reach out to sections at the medevac post for possible assignments matching your skills.

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1.4.9 Training

If in Washington, D.C. for medevac, you may take training at FSI. Supervisor or training officer authorization is required. FSI training does not qualify for medevac per diem, but per diem may apply if attending under non-medevac TDY rules.

Online training may be an option regardless of location, but set clear expectations with your supervisor. Know which office owns your billet and obtain necessary approvals. If lacking paid leave, consider combining paid leave with LWOP. Leave can be combined with training.

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1.5 MEDEVAC, Travel, Per Diem and Allowances

MEDEVAC and paid parental leave are two separate policies. OB Medevac addresses the physical health and well-being of the birth parent prior to and after birth. Paid parental leave is a leave policy designed to allow birth and non-birth parents to recuperate and bond with their new baby.

While on your medevac, you will be eligible for per diem that covers lodging, meals and incidental expenses (M&IE), and reimbursement for other travel-related costs. Invoking paid parental leave post-birth does not impact your medevac per diem. However, allowances associated with your post (e.g., COLA, hardship differential, LIP) may be affected. This section details those allowances.

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1.5.1 Per Diem

Per diem includes lodging and M&IE, based on your approved medevac location. Certain lodging types are not reimbursed (e.g., personally owned residences). Special cases such as RVs or lodging with friends may be reimbursed with proper documentation and approval.

Full per diem applies throughout the medevac period (unlike training). If delivering abroad (away from post), per diem is cost-constructed against Washington, D.C. rates. No per diem is granted for unauthorized locations.

Children on your orders may be authorized to accompany you. Per diem rates are set by GSA and the State Department. See current rates at: GSA Domestic Rates | Foreign Per Diem Rates

If traveling to post after 34 weeks gestation, OB medevac will not be authorized. All employees must comply with the prudent traveler rule. Housing must align with market rates. Per diem may be denied if costs are excessive.

Per diem includes travel time to and from the medevac site. OB medevac typically authorizes up to 90 days of per diem (45 days before and after delivery). Extensions may apply with medical documentation.

Hospitalization: lodging only (no M&IE) for up to 2 days (non-surgical) or 3 days (surgical). Additional days require medical approval.

No connection exists between medevac per diem and parental leave. You may combine medevac with paid/unpaid leave types. Newborns receive 50% of local rate per diem, excluding hospitalization.

You may apply for a travel advance covering up to 45 days. Early delivery shortens eligibility; you must repay excess advance. Per diem does not extend due to documentation delays (birth certificate, passport, visa).

Per diem is not authorized during home leave or other official travel orders (e.g., evacuation). If your post goes on departure orders during medevac, medevac terms continue until expiration, then convert to alternate allowances.

FSI-specific: If attending FSI with onward overseas orders, you may qualify for OB medevac per diem upon submitting TM4 and OB medical report. During that time, you must be on approved leave and removed from FSI per diem.

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1.5.2 Continuation of Per Diem While in Training at FSI

Employees who invoke paid parental leave while in long-term training at FSI will continue to receive per diem during the FMLA period, not exceeding 12 weeks. This policy, effective November 19, 2020, is reflected in 14 FAM 574.5.2. Coordinate with your Assignment Officer to ensure inclusion of per diem in your orders.

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1.5.3 Accompanying Minor Children

Minor children listed on your post assignment orders and unable to care for themselves may be authorized to travel on medevac. EFMs incapable of self-support can travel separately from the birth parent (“non-concurrent travel”).

• Children under 12: 50% of adult per diem
• Children 12 and older: 75% of adult per diem
• One child: 100% lodging on days the parent is hospitalized beyond 2 (non-surgical) or 3 (surgical)

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1.5.4 New Child EVT (Travel of non-birth parent)

1.5.4 New Child EVT (Travel of non-birth parent)

As of April 2021, changes to Emergency Visitation Travel (EVT) in 3 FAM 3746.6 and 3 FAH-1 H-3747 established the New Child EVT. This benefit is available in two situations:

1. A birth parent departs post on OB medevac orders, and the non-birth parent travels on New Child EVT orders to join the birth parent at the medevac location.
2. The birth parent and non-birth parent are in different locations, and the birth parent is not on OB medevac travel orders (e.g., the non-birth parent is at an unaccompanied post and the birth parent is residing in the United States).

Like other categories of EVT, per diem is not authorized. For more information, review 3 FAM 3740 or contact EmergencyVisitationTravel@state.gov.

Note: As of December 2021, the New Child EVT benefit expanded to foreign service employees and their eligible family members welcoming a new child through adoption, fostering, or surrogacy. More info: 21 State 127800.

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1.5.5 Living Quarters Allowance (LQA)

If you take LWOP for more than 30 days at one time, your LQA is suspended starting from the first day of LWOP. Consider structuring your leave to protect this allowance. Note: At posts with government housing, it is not State Department policy to remove new mothers from housing while on LWOP.

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1.5.6 Danger Pay

Danger Pay ends at close of business the day you depart post for any location not designated for the danger pay allowance, including medevac.

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1.5.7 Post Hardship Differential

Continues for up to 42 days after you leave post if a family member remains. If not, it ends on your departure date and resumes when you return. It is suspended if you enter LWOP status.

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1.5.8 Service Need Differential (SND)

SND is calculated and paid annually by the Charleston Payroll Service Center. Absences over 30 days reduce the lump sum payment on a pro-rated basis. Absences of 30 days or fewer do not affect SND.

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1.5.9 Cost of Living Allowance (COLA)

If in pay status, COLA continues for 30 days of medevac. If no family remains at post, it stops on day 31. If family remains, COLA is reduced. For LWOP over 14 days, COLA stops for you and your family. LWOP of 14 days or less does not interrupt the 30-day COLA continuation.

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1.5.10 Language Incentive Pay (LIP)

LIP is unaffected by absences of 30 days or fewer. It stops on day 31 and resumes when you return to post. Post must notify payroll servicing office by cable.

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1.5.11 Education Allowance

Education allowances continue even if children accompany you on medevac.

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1.5.12 Holidays

If on paid leave before or after a U.S. holiday, you don’t need to use leave for the holiday. LWOP status disqualifies you for paid holidays. Local holidays aren’t authorized during medevac travel.

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1.5.13 Federal Employee Health Benefits plan (FEHBP)

FEHBP continues for up to 365 days during non-pay status. Beyond that, re-enrollment with Form DS-5112 is required upon return to duty.

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1.5.14 Layette Shipment/UAB Shipment

A layette shipment allows up to 250 pounds of airfreight for infant care items for a newborn or adopted child under five, assigned to post. Only infant-related items are eligible.

Post must certify lack of suitable local layette supplies. Coordinate with your GTMO at post to request authorization via cable to GTM/EX/IDSD. This shipment is not part of medevac orders.

Arrange shipment with A/LM/OPS/TTM. Shipments may begin 120 days before birth and must occur no later than 60 days after birth.

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2. Before You Leave Post

By week 28 of pregnancy, you should decide your delivery location and begin securing travel orders and fund cite. While travel cannot begin until telegrams are issued, reservations can be made. Departure is allowed up to 45 days before expected delivery, earlier if medically required.

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2.1 Travel Orders and Fund Cite

By week 30 (or four weeks before planned departure), contact your health unit, RMO, or FSMP to obtain travel orders and fund cite. Post must send a medevac authorization cable and a referral letter with relevant medical and logistical information to MED/FP.

Details in the cable and letter may include:

• Last Menstrual Period and Estimated Due Date
• Medevac destination and contact details
• Attending OB info and hospital name
• Health insurance details
• Departure date and accompanying children
• Home leave or PCS eligibility

MED will respond with:

1. A medevac authorization cable with instructions
2. A funding cable (MED CHANNEL) with fund cite and reimbursement guidance

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2.2 Travel Advance

Before departing, apply for per diem advance through your FMO using your fiscal data cable. This can also be done upon arrival in Washington, D.C. (not available for non-D.C. medevac locations).

Eligible travelers (birth parent and dependents) may receive 80% of per diem in advance, not exceeding the estimated cost for 45 days of travel.

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2.3 Approximately 2 Weeks Prior to Departure

If you are delivering at an overseas location, schedule a meeting with the medevac post’s health unit and, if appropriate, with the RSO (especially if you plan to work on a TDY while at your medevac location). Schedule an appointment with your receiving obstetrician/hospital where you plan to deliver. Inquire whether there are any specific requirements for issuing a local birth certificate.

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2.4 Approximately 1 Week Prior to Departure

You must obtain a letter from your doctor or the health unit for the airline certifying that you are medically fit for travel by commercial airline.

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3. Travel/Arrival at Your Medevac Location

Post should issue you (and your minor children if applicable) unrestricted ticket(s) with open return.

While MED will send some of the following documents after you arrive, it is a good idea to bring your own copies:

• Contact info of your GTM/EX HR Technician
• Prenatal medical records in English
• Health insurance info
• For overseas delivery, also bring:
• Blank Form OF-126
• Blank Form DS-11 (U.S. Passport Application)
• Blank Form DS-2029 (CRBA Application)
• DS-3067 Letter of Authorization
• ACS unit chief contact info
• Blank Form DS-3053 if both parents won’t be present at passport application

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3.1 Immediately After Arrival

After arriving at your medevac location, the birth parent must immediately contact the OB Medevac Coordinator at 202.663.1662 or email MedForeignPrograms@state.gov.

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3.2 Supplemental Voucher

30 or 45 days after arrival, if you received a travel advance for the first 45 days, submit a supplemental voucher (Form OF-261) to request the remaining 45 days. If your advance covered fewer days, submit once that period has passed.

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4. Baby Is Here!

Congratulations on the arrival of your bundle of joy! While you recover and care for your baby, there are several steps to take before returning to post.

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4.1 Immediately After Birth

Contact the OB Medevac Coordinator at 202.663.1662 or email MedForeignPrograms@state.gov to report the birth and begin the medical clearance process.

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4.2 Documentation Needed before Returning to Post

4.2.1 Birth Certificate

You must obtain an official birth certificate issued by the hospital or local authority. Confirm the hospital has initiated the process and whether they can expedite it. If delivering in Virginia, you may apply at the DMV.

For foreign language certificates, a notarized English translation is required. GTM/EX/IDSD does not accept non-translated certificates. Third-party translated and ACS-notarized documents are also required for adding dependents to FEHB.

NOTE: GTM/EX/IDSD will accept a Consular Report of Birth Abroad (CRBA). See 4.2.2.

Obtain at least two copies—one for passport applications and one for your records.

Domestic Delivery: Once the birth certificate is issued, apply immediately for a diplomatic passport at an authorized acceptance facility. If needed, email CA-PPT-SIA-PASSPORTS@state.gov for assistance.

Overseas Delivery: Apply immediately for a CRBA to begin the dependent addition process. See 4.2.2 for more details.

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4.2.2 Consular Report of Birth Abroad (CRBA)

If your baby is born abroad, you should seek a CRBA in addition to the birth certificate. The CRBA is not a birth certificate; it is proof of U.S. citizenship issued by the U.S. Embassy or Consulate where the baby was born. Many ACS Units use an appointment system—check with the applicable post before the birth. More info: travel.state.gov

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4.2.3 Adding the New Baby as a Dependent

Submit Form OF-126 with the birth certificate (in English) or CRBA to your HR Technician in GTM/EX/IDSD.

If you have OpenNet access, use “GEMS Self-Service” via GTM Portal to submit or update OF-126 online.

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4.2.4 Baby’s Passport

The baby must have a diplomatic or official passport matching the employee’s status. Additional per diem is not authorized for delays in passport processing. Processing from overseas is usually expedited.

After GTM/EX updates your travel profile, they will send an electronic Request for Passport Services (eRPS) for your baby’s application. Stay in regular contact with your Assignment Technician.

Do not wait for the SSN to apply. You can submit an affidavit stating that the number has not been issued yet.

Application guidance: travel.state.gov/sia (only from gov devices). Email CA-PPT-SIA-PASSPORTS@state.gov if needed. Both parents must be present. If one is absent, use notarized Form DS-3053 with ID copy.

If applying at a non-State Department location, save the receipt. It is reimbursable.

Back to Table of Contents Part 1

4.2.5 Baby’s Visa

If born in the U.S., your baby may need a visa to return to post. Once the passport is issued, sign it and follow visa guidance at travel.state.gov/sia. If access is not available, email CA-PPT-SIA-VISA-UNIT@state.gov.

If born overseas, coordinate with your post’s Management Section for visa or residency permit requirements. If born in a third country, both the home and birth country posts should coordinate the visa process.

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4.2.6 Medical Clearances (4 weeks after birth)

Clearance is granted after your GTM/EX HR Technician receives a new OF-126. A pediatrician must complete DS-1622 when the baby is at least 4 weeks old. Your OB must complete the ACOG postpartum form, typically 4–6 weeks after delivery.

If OpenNet is unavailable, request a copy of the travel authorization via personal email. Inform your Management Officer of any clearance changes. You cannot return to post until medical clearance is reinstated.

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4.2.7 Airline Tickets for Travel Back to Post

Your baby must have a separate ticket unless you are assigned within 50 miles of your medevac location. Travel is authorized under amended PCS orders—not medevac orders—after medical clearance and receipt of the ACOG Postnatal Form.

Send amended orders to DOSTA@cwtsatotravel.com. Call TMC at 1-866-654-5593 (HST) for reservations. Infants must be on the same reservation as an adult. MED recommends waiting until 6 weeks of age to fly.

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4.2.8 Adding Baby to Your Health Benefits (within 60 days after birth)

If you already have ‘Self and Family’ coverage, just inform your health plan. If you are on ‘Self’ or ‘Self Plus One,’ you must submit SF-2809 and proof (birth certificate in English) within 60 days of the birth. Late submission requires waiting for Open Season.

Back to Table of Contents Part 1

APPENDIX 2: Timeline Cheat Sheet

• Early on in your pregnancy: Notify post health unit or Regional Medical Officer (RMO).
• Before 18 weeks: Prenatal screening recommended between 10–23 weeks and at 18–22 weeks gestation.
• 28–30 weeks: Obtain travel orders, travel fund cite, and copies of authorizing/budget cables.
• Travel Reservations: Reserve tickets and lodging (even before travel orders are received).
• Apply for Travel Advance.
• Obtain DS-3067 and a travel fitness letter from your provider.
• Collect all required documents and info to bring with you.
• Immediately upon arrival at medevac point, contact MED Foreign Programs.
• 30 or 45 days post-arrival: Submit supplemental voucher if applicable.
• Immediately after birth: Contact MED/FP with baby’s birth stats.
• Obtain birth certificate as soon as possible.
• Add the baby as a dependent by submitting OF-126 and birth proof; send updated OF-126 to MED/Records.
• If delivering overseas, obtain CRBA from local consulate.
• Apply for passport either at SIA or consulate.
• Obtain a visa for your baby if required.
• 4 weeks after birth: Submit DS-1622 to MED/FP for clearance and amended orders.
• 4–6 weeks after birth: Submit ACOG form to reinstate your clearance.
• Send amended orders to TMC or travel unit at DOSTA@cwtsatotravel.com.
• Within 7 days of return to post: File your travel vouchers with FMO.

Back to Table of Contents Part 1

APPENDIX 3: Calculating Per Diem + Example

Your medevac fund cite cable will specify the max amounts for lodging and M&IE during your medevac. These may adjust based on the actual birth date.

To estimate per diem beforehand, use the current GSA CONUS per diem rates: GSA Per Diem Rates.

Calculation depends on:

• Number of travelers
• Days in a specific month
• Hospitalization days (no per diem except for minor child)
• Actual birth date

Example:

Traveling with one minor child (50% per diem). Baby is born March 5. Depart post Jan 21 and return Apr 20. 3 hospital days (only child receives per diem).

Authorized: $10,898.50 for M&IE (no receipts required), and $32,109.50 for lodging (receipts required). Lodging costs should not exceed market rates for temporary housing.

Back to Table of Contents Part 1

APPENDIX 2: Timeline Cheat Sheet

• Early on in your pregnancy: Notify post health unit or Regional Medical Officer (RMO).
• Before 18 weeks: Prenatal screening recommended between 10–23 weeks and at 18–22 weeks gestation.
• 28–30 weeks: Obtain travel orders, travel fund cite, and copies of authorizing/budget cables.
• Travel Reservations: Reserve tickets and lodging (even before travel orders are received).
• Apply for Travel Advance.
• Obtain DS-3067 and a travel fitness letter from your provider.
• Collect all required documents and info to bring with you.
• Immediately upon arrival at medevac point, contact MED Foreign Programs.
• 30 or 45 days post-arrival: Submit supplemental voucher if applicable.
• Immediately after birth: Contact MED/FP with baby’s birth stats.
• Obtain birth certificate as soon as possible.
• Add the baby as a dependent by submitting OF-126 and birth proof; send updated OF-126 to MED/Records.
• If delivering overseas, obtain CRBA from local consulate.
• Apply for passport either at SIA or consulate.
• Obtain a visa for your baby if required.
• 4 weeks after birth: Submit DS-1622 to MED/FP for clearance and amended orders.
• 4–6 weeks after birth: Submit ACOG form to reinstate your clearance.
• Send amended orders to TMC or travel unit at DOSTA@cwtsatotravel.com.
• Within 7 days of return to post: File your travel vouchers with FMO.

Back to Table of Contents Part 1

APPENDIX 3: Calculating Per Diem + Example

Your medevac fund cite cable will specify the max amounts for lodging and M&IE during your medevac. These may adjust based on the actual birth date.

To estimate per diem beforehand, use the current GSA CONUS per diem rates: GSA Per Diem Rates.

Calculation depends on:

• Number of travelers
• Days in a specific month
• Hospitalization days (no per diem except for minor child)
• Actual birth date

Example:

Traveling with one minor child (50% per diem). Baby is born March 5. Depart post Jan 21 and return Apr 20. 3 hospital days (only child receives per diem).

Authorized: $10,898.50 for M&IE (no receipts required), and $32,109.50 for lodging (receipts required). Lodging costs should not exceed market rates for temporary housing.

Back to Table of Contents Part 1

APPENDIX 4: Quick List of Forms Relevant to Obstetric Medevac

(To be filled with relevant form names and purposes as needed.)

Back to Table of Contents Part 1

APPENDIX 5: Useful Sites for Regulations Related to OB Medevac and Leave

• 3 FAM 3530 FMLA and Paid Parental Leave

Back to Table of Contents Part 1

APPENDIX 2: Timeline Cheat Sheet

• Early on in your pregnancy: Notify post health unit or Regional Medical Officer (RMO).
• Before 18 weeks: Prenatal screening recommended between 10–23 weeks and at 18–22 weeks gestation.
• 28–30 weeks: Obtain travel orders, travel fund cite, and copies of authorizing/budget cables.
• Travel Reservations: Reserve tickets and lodging (even before travel orders are received).
• Apply for Travel Advance.
• Obtain DS-3067 and a travel fitness letter from your provider.
• Collect all required documents and info to bring with you.
• Immediately upon arrival at medevac point, contact MED Foreign Programs.
• 30 or 45 days post-arrival: Submit supplemental voucher if applicable.
• Immediately after birth: Contact MED/FP with baby’s birth stats.
• Obtain birth certificate as soon as possible.
• Add the baby as a dependent by submitting OF-126 and birth proof; send updated OF-126 to MED/Records.
• If delivering overseas, obtain CRBA from local consulate.
• Apply for passport either at SIA or consulate.
• Obtain a visa for your baby if required.
• 4 weeks after birth: Submit DS-1622 to MED/FP for clearance and amended orders.
• 4–6 weeks after birth: Submit ACOG form to reinstate your clearance.
• Send amended orders to TMC or travel unit at DOSTA@cwtsatotravel.com.
• Within 7 days of return to post: File your travel vouchers with FMO.

Back to Table of Contents Part 1

APPENDIX 3: Calculating Per Diem + Example

Your medevac fund cite cable will specify the max amounts for lodging and M&IE during your medevac. These may adjust based on the actual birth date.

To estimate per diem beforehand, use the current GSA CONUS per diem rates: GSA Per Diem Rates.

Calculation depends on:

• Number of travelers
• Days in a specific month
• Hospitalization days (no per diem except for minor child)
• Actual birth date

Example:

Traveling with one minor child (50% per diem). Baby is born March 5. Depart post Jan 21 and return Apr 20. 3 hospital days (only child receives per diem).

Authorized: $10,898.50 for M&IE (no receipts required), and $32,109.50 for lodging (receipts required). Lodging costs should not exceed market rates for temporary housing.

Back to Table of Contents Part 1

APPENDIX 4: Quick List of Forms Relevant to Obstetric Medevac

(To be filled with relevant form names and purposes as needed.)

Back to Table of Contents Part 1

APPENDIX 5: Useful Sites for Regulations Related to OB Medevac and Leave

• 3 FAM 3530 FMLA and Paid Parental Leave

Back to Table of Contents Part 1

Part Two: Pregnancy and Childbirth Guidance for Employees INCLUDING OBSTETRIC MEDEVAC

Congratulations on the new addition to your family! This section of our New Parent Guide is for all State Department Civil and Foreign Service employees, domestic and overseas, considering or currently in the process of adopting or fostering a child. This edition incorporates the new paid parental provisions under the Family Medical Leave Act (FMLA) which became effective October 1, 2020 and replaces the previous Adoption Guide published in September 2016.

1.1.1 Applying for Paid Parental Leave

You must apply to receive paid parental leave. A thirty (30) day notice is required whenever possible; otherwise notice is required as soon as possible. You can start the process BEFORE adoption/placement process – but PPL won’t begin until the actual day when the child (adopted or foster) is physically placed into your care.

Required forms:

• Form DS-1923 to invoke FMLA
• Form DS-5154, Work Obligation Agreement
• Form DS-5155, Request for Paid Parental Leave (PPL)

Required Process:

• Submit all three forms to your supervisor. Supervisor approves DS-1923 and DS-5155.
• DS-5154 is required but not signed by supervisor.
• Provide legal documentation of adoption placement within 15 calendar days.
• After bureau executive approval, HR sends DS-1923 & DS-5155 to CGFS PAYINTAKE@state.gov to open a PPL account.

Back to Table of Contents Part 2

1.1.2 “Stacking” Personal Leave and Paid Parental Leave

You may request to use annual leave or sick leave in addition to invoking paid parental leave under FMLA. This is known as “stacking” leave and is permitted subject to standard approval rules.

Example: Jenny adopts a baby girl on Dec 1, 2020. She uses 2 weeks of annual leave, then 12 weeks of paid parental leave. Her FMLA entitlement ends Dec 1, 2021.

Back to Table of Contents Part 2

1.2 Accrued Sick Leave

You are entitled to use sick leave for adoption-related purposes including:

• Appointments with agencies/lawyers
• Court proceedings
• Required travel or bonding as mandated

No limit on sick leave for adoption purposes. Sick leave for adoption does not count toward annual family care limits.

Fostering alone (without adopting) does not entitle you to adoption-related sick leave.

For children with serious health conditions: up to 12 weeks sick leave per year. For routine care: 13 days (104 hours) max.

For eligibility: child must meet OPM’s definition of son/daughter. In loco parentis relationships are included.

Back to Table of Contents Part 2

1.3 Advanced Sick Leave

If you run out of sick leave, you may request up to:

• 240 hours (6 weeks) for adoption-related medical need
• 104 hours (2.5 weeks) for routine care

Documentation is required. Advanced sick leave is repaid as you earn it (4 hours per pay period). Shared leave can be used to liquidate balances.

If you separate from the agency with negative leave, you must repay it.

More info:

• OPM’s Fact Sheet: Advanced Sick Leave
• OPM’s Fact Sheet: Sick Leave for Adoption

Back to Table of Contents Part 2

APPENDIX 2: Timeline Cheat Sheet

• Early on in your pregnancy: Notify post health unit or Regional Medical Officer (RMO).
• Before 18 weeks: Prenatal screening recommended between 10–23 weeks and at 18–22 weeks gestation.
• 28–30 weeks: Obtain travel orders, travel fund cite, and copies of authorizing/budget cables.
• Travel Reservations: Reserve tickets and lodging (even before travel orders are received).
• Apply for Travel Advance.
• Obtain DS-3067 and a travel fitness letter from your provider.
• Collect all required documents and info to bring with you.
• Immediately upon arrival at medevac point, contact MED Foreign Programs.
• 30 or 45 days post-arrival: Submit supplemental voucher if applicable.
• Immediately after birth: Contact MED/FP with baby’s birth stats.
• Obtain birth certificate as soon as possible.
• Add the baby as a dependent by submitting OF-126 and birth proof; send updated OF-126 to MED/Records.
• If delivering overseas, obtain CRBA from local consulate.
• Apply for passport either at SIA or consulate.
• Obtain a visa for your baby if required.
• 4 weeks after birth: Submit DS-1622 to MED/FP for clearance and amended orders.
• 4–6 weeks after birth: Submit ACOG form to reinstate your clearance.
• Send amended orders to TMC or travel unit at DOSTA@cwtsatotravel.com.
• Within 7 days of return to post: File your travel vouchers with FMO.

Back to Table of Contents Part 1

APPENDIX 3: Calculating Per Diem + Example

Your medevac fund cite cable will specify the max amounts for lodging and M&IE during your medevac. These may adjust based on the actual birth date.

To estimate per diem beforehand, use the current GSA CONUS per diem rates: GSA Per Diem Rates.

Calculation depends on:

• Number of travelers
• Days in a specific month
• Hospitalization days (no per diem except for minor child)
• Actual birth date

Example:

Traveling with one minor child (50% per diem). Baby is born March 5. Depart post Jan 21 and return Apr 20. 3 hospital days (only child receives per diem).

Authorized: $10,898.50 for M&IE (no receipts required), and $32,109.50 for lodging (receipts required). Lodging costs should not exceed market rates for temporary housing.

Back to Table of Contents Part 1

APPENDIX 4: Quick List of Forms Relevant to Obstetric Medevac

(To be filled with relevant form names and purposes as needed.)

Back to Table of Contents Part 1

APPENDIX 5: Useful Sites for Regulations Related to OB Medevac and Leave

• 3 FAM 3530 FMLA and Paid Parental Leave

Back to Table of Contents Part 1

Part Two: Pregnancy and Childbirth Guidance for Employees INCLUDING OBSTETRIC MEDEVAC

Congratulations on the new addition to your family! This section of our New Parent Guide is for all State Department Civil and Foreign Service employees, domestic and overseas, considering or currently in the process of adopting or fostering a child. This edition incorporates the new paid parental provisions under the Family Medical Leave Act (FMLA) which became effective October 1, 2020 and replaces the previous Adoption Guide published in September 2016.

APPENDIX 2: Timeline Cheat Sheet

• Early on in your pregnancy: Notify post health unit or Regional Medical Officer (RMO).
• Before 18 weeks: Prenatal screening recommended between 10–23 weeks and at 18–22 weeks gestation.
• 28–30 weeks: Obtain travel orders, travel fund cite, and copies of authorizing/budget cables.
• Travel Reservations: Reserve tickets and lodging (even before travel orders are received).
• Apply for Travel Advance.
• Obtain DS-3067 and a travel fitness letter from your provider.
• Collect all required documents and info to bring with you.
• Immediately upon arrival at medevac point, contact MED Foreign Programs.
• 30 or 45 days post-arrival: Submit supplemental voucher if applicable.
• Immediately after birth: Contact MED/FP with baby’s birth stats.
• Obtain birth certificate as soon as possible.
• Add the baby as a dependent by submitting OF-126 and birth proof; send updated OF-126 to MED/Records.
• If delivering overseas, obtain CRBA from local consulate.
• Apply for passport either at SIA or consulate.
• Obtain a visa for your baby if required.
• 4 weeks after birth: Submit DS-1622 to MED/FP for clearance and amended orders.
• 4–6 weeks after birth: Submit ACOG form to reinstate your clearance.
• Send amended orders to TMC or travel unit at DOSTA@cwtsatotravel.com.
• Within 7 days of return to post: File your travel vouchers with FMO.

Back to Table of Contents Part 1

APPENDIX 3: Calculating Per Diem + Example

Your medevac fund cite cable will specify the max amounts for lodging and M&IE during your medevac. These may adjust based on the actual birth date.

To estimate per diem beforehand, use the current GSA CONUS per diem rates: GSA Per Diem Rates.

Calculation depends on:

• Number of travelers
• Days in a specific month
• Hospitalization days (no per diem except for minor child)
• Actual birth date

Example:

Traveling with one minor child (50% per diem). Baby is born March 5. Depart post Jan 21 and return Apr 20. 3 hospital days (only child receives per diem).

Authorized: $10,898.50 for M&IE (no receipts required), and $32,109.50 for lodging (receipts required). Lodging costs should not exceed market rates for temporary housing.

Back to Table of Contents Part 1

APPENDIX 4: Quick List of Forms Relevant to Obstetric Medevac

(To be filled with relevant form names and purposes as needed.)

Back to Table of Contents Part 1

APPENDIX 5: Useful Sites for Regulations Related to OB Medevac and Leave

• 3 FAM 3530 FMLA and Paid Parental Leave

Back to Table of Contents Part 1

Part Two: Pregnancy and Childbirth Guidance for Employees INCLUDING OBSTETRIC MEDEVAC

Congratulations on the new addition to your family! This section of our New Parent Guide is for all State Department Civil and Foreign Service employees, domestic and overseas, considering or currently in the process of adopting or fostering a child. This edition incorporates the new paid parental provisions under the Family Medical Leave Act (FMLA) which became effective October 1, 2020 and replaces the previous Adoption Guide published in September 2016.

APPENDIX 2: Timeline Cheat Sheet

• Early on in your pregnancy: Notify post health unit or Regional Medical Officer (RMO).
• Before 18 weeks: Prenatal screening recommended between 10–23 weeks and at 18–22 weeks gestation.
• 28–30 weeks: Obtain travel orders, travel fund cite, and copies of authorizing/budget cables.
• Travel Reservations: Reserve tickets and lodging (even before travel orders are received).
• Apply for Travel Advance.
• Obtain DS-3067 and a travel fitness letter from your provider.
• Collect all required documents and info to bring with you.
• Immediately upon arrival at medevac point, contact MED Foreign Programs.
• 30 or 45 days post-arrival: Submit supplemental voucher if applicable.
• Immediately after birth: Contact MED/FP with baby’s birth stats.
• Obtain birth certificate as soon as possible.
• Add the baby as a dependent by submitting OF-126 and birth proof; send updated OF-126 to MED/Records.
• If delivering overseas, obtain CRBA from local consulate.
• Apply for passport either at SIA or consulate.
• Obtain a visa for your baby if required.
• 4 weeks after birth: Submit DS-1622 to MED/FP for clearance and amended orders.
• 4–6 weeks after birth: Submit ACOG form to reinstate your clearance.
• Send amended orders to TMC or travel unit at DOSTA@cwtsatotravel.com.
• Within 7 days of return to post: File your travel vouchers with FMO.

Back to Table of Contents Part 1

APPENDIX 3: Calculating Per Diem + Example

Your medevac fund cite cable will specify the max amounts for lodging and M&IE during your medevac. These may adjust based on the actual birth date.

To estimate per diem beforehand, use the current GSA CONUS per diem rates: GSA Per Diem Rates.

Calculation depends on:

• Number of travelers
• Days in a specific month
• Hospitalization days (no per diem except for minor child)
• Actual birth date

Example:

Traveling with one minor child (50% per diem). Baby is born March 5. Depart post Jan 21 and return Apr 20. 3 hospital days (only child receives per diem).

Authorized: $10,898.50 for M&IE (no receipts required), and $32,109.50 for lodging (receipts required). Lodging costs should not exceed market rates for temporary housing.

Back to Table of Contents Part 1

APPENDIX 4: Quick List of Forms Relevant to Obstetric Medevac

(To be filled with relevant form names and purposes as needed.)

Back to Table of Contents Part 1

APPENDIX 5: Useful Sites for Regulations Related to OB Medevac and Leave

• 3 FAM 3530 FMLA and Paid Parental Leave

Back to Table of Contents Part 1

Part Two: Pregnancy and Childbirth Guidance for Employees INCLUDING OBSTETRIC MEDEVAC

Congratulations on the new addition to your family! This section of our New Parent Guide is for all State Department Civil and Foreign Service employees, domestic and overseas, considering or currently in the process of adopting or fostering a child. This edition incorporates the new paid parental provisions under the Family Medical Leave Act (FMLA) which became effective October 1, 2020 and replaces the previous Adoption Guide published in September 2016.

APPENDIX 2: Timeline Cheat Sheet

• Early on in your pregnancy: Notify post health unit or Regional Medical Officer (RMO).
• Before 18 weeks: Prenatal screening recommended between 10–23 weeks and at 18–22 weeks gestation.
• 28–30 weeks: Obtain travel orders, travel fund cite, and copies of authorizing/budget cables.
• Travel Reservations: Reserve tickets and lodging (even before travel orders are received).
• Apply for Travel Advance.
• Obtain DS-3067 and a travel fitness letter from your provider.
• Collect all required documents and info to bring with you.
• Immediately upon arrival at medevac point, contact MED Foreign Programs.
• 30 or 45 days post-arrival: Submit supplemental voucher if applicable.
• Immediately after birth: Contact MED/FP with baby’s birth stats.
• Obtain birth certificate as soon as possible.
• Add the baby as a dependent by submitting OF-126 and birth proof; send updated OF-126 to MED/Records.
• If delivering overseas, obtain CRBA from local consulate.
• Apply for passport either at SIA or consulate.
• Obtain a visa for your baby if required.
• 4 weeks after birth: Submit DS-1622 to MED/FP for clearance and amended orders.
• 4–6 weeks after birth: Submit ACOG form to reinstate your clearance.
• Send amended orders to TMC or travel unit at DOSTA@cwtsatotravel.com.
• Within 7 days of return to post: File your travel vouchers with FMO.

Back to Table of Contents Part 1

APPENDIX 3: Calculating Per Diem + Example

Your medevac fund cite cable will specify the max amounts for lodging and M&IE during your medevac. These may adjust based on the actual birth date.

To estimate per diem beforehand, use the current GSA CONUS per diem rates: GSA Per Diem Rates.

Calculation depends on:

• Number of travelers
• Days in a specific month
• Hospitalization days (no per diem except for minor child)
• Actual birth date

Example:

Traveling with one minor child (50% per diem). Baby is born March 5. Depart post Jan 21 and return Apr 20. 3 hospital days (only child receives per diem).

Authorized: $10,898.50 for M&IE (no receipts required), and $32,109.50 for lodging (receipts required). Lodging costs should not exceed market rates for temporary housing.

Back to Table of Contents Part 1

APPENDIX 4: Quick List of Forms Relevant to Obstetric Medevac

(To be filled with relevant form names and purposes as needed.)

Back to Table of Contents Part 1

APPENDIX 5: Useful Sites for Regulations Related to OB Medevac and Leave

• 3 FAM 3530 FMLA and Paid Parental Leave

Back to Table of Contents Part 1

Part Two: Pregnancy and Childbirth Guidance for Employees INCLUDING OBSTETRIC MEDEVAC

Congratulations on the new addition to your family! This section of our New Parent Guide is for all State Department Civil and Foreign Service employees, domestic and overseas, considering or currently in the process of adopting or fostering a child. This edition incorporates the new paid parental provisions under the Family Medical Leave Act (FMLA) which became effective October 1, 2020 and replaces the previous Adoption Guide published in September 2016.