Tricare: Oh, How My Head Hurts

For the last 2 1/2 years, I have been able to use a civilian pediatrician instead of a military one.  In some ways, they are the same: often, I had to wait for quite some time for my appointment, long past the scheduled time.  In some ways, they could be worse: they had the right to decline me as a patient if I didn’t give my children the vaccines they felt were necessary.  And in some ways they were better: they had an office open for sick children on weekends, which I went to more than once for ear infections.

In one way, they were superior: I could always make the necessary appointments for my children.

This, unfortunately, is not always the case with the military health care system.

Case in point: today’s frustration, which began two weeks ago.

We moved here.  I noticed George was tongue-tied.  Bill found out we could enroll into the local Tricare system online.  So he did.  They had options for PCMs.  A neighbor had recommended their civilian pediatrician, and this pediatrician was listed.  Bill selected them.  I called the pediatrician and was able to get my (starving) newborn in during their evening sick child hours that very day.  They also gave me the necessary referral to the lactation consultants at the local hospital and a list of ENTs (who got me in the day I called to clip his tongue).  I called the pediatrician the next day and scheduled his two week newborn appointment for the following week.  At that appointment, I scheduled a follow-up appointment for his one month mark because he was barely gaining the required weight.

Then we received notice in the mail from Tricare that we could not use this civilian provider because there was a local military clinic.

Bill called Tricare today and explained the situation with George and asked that an exception be made for just him until we get past this “crisis.”  Nope.  We must go to the military clinic.

So I called the clinic to make an appointment for this one month follow up to make sure that my starving baby is properly gaining weight.  His one month mark is next week – can you believe it?? me, neither! – and the man at the appointment line (very nice man, BTW, very sympathetic) knew the reason the child was being brought in was because of his weight, but the best he could offer me was August 21st.  4 weeks…6 weeks…if the baby isn’t thriving, do 2 more weeks really make a big difference?  Nah, I’m sure he’ll be fine…

So I suggested we make his 2 month appointment, since if we’re waiting until 6 weeks, we might as well just skip it and do the next one (and because this is my 7th kid and I have a scale and I know he’s not starving, even though I didn’t tell the appointment guy all this).  Oh, but they can only make appointments 4 weeks out, and his 2 month mark is 5 weeks out.  I need to call back next week to schedule that.

This clinic is also where I am supposed to go, so I asked if I could make my 6 week postpartum appointment.  He asked if I wanted to go to the OB/GYNs at MacDill (40 minutes away) or to my PCM.  I asked if my PCM was male or female.  Male.  I asked if there were any female doctors at the clinic.  No.  I asked if there was a nurse practitioner at the clinic.  No.  I said I preferred to go to the OB/GYNs then.  He said that was fine, but he would have to transfer me to them to make the appointment.  He transferred me.  I got voice mail.

No starving baby check up appointment made.
No 2 month well baby appointment made.
No postpartum appointment made.

Like I said, I never had difficulty making appointments with civilian providers. 

And the Tricare website?  Why do they list providers you can’t use?  Then when I went to the site to learn who our PCMs were, all it listed was a name.  No address, no phone number.  I had to call their unfriendly central number to get the number of the local appointment line.  I have yet to find anything useful about their website.

In all fairness, I will say the OB clinic called back within an hour and did get me an appointment within the appropriate date range.  I have no idea if the provider is male or female.  When I asked if I had a choice, the person on the phone said there were only two providers at that clinic.  So, I must use their providers, but they have so few that I’m stuck with whatever they have, regardless of personal preferences.

Oh, they did tell my husband that we could have more choices if we used Tricare Standard instead of Prime.  Naturally, there are disadvantages to using this system instead, most specifically: higher out-of-pocket costs.  It’s something I’ll have to think about.

This is the way government health care works.  Coming soon to everybody.  Hooray for us.

13 thoughts on “Tricare: Oh, How My Head Hurts

  1. Yep. Been there. Still there.

  2. Been there too. And that is why we have Standard and NEVER Prime. No way, no how. Totally worth the extra out of pocket costs. Which aren't that significant. Having been on civilian healthcare programs through my husband's “regular” job and then on Tricare when he was deployed, the out-of-pocket is WAY less with Tricare. We opted to stay on Reserve Select, even though he's off deployment because of that. Select is the Reservist version of Standard.

  3. Sooo frustrating, isn't it?!?!?!

  4. As a military family we feel your pain, hang in there …

  5. I absolutely do not regret our decision to go standard! We have a pediatrician we love, got speech therapy without a referral (Ped just wrote us a script for it and voila), and I've been able to take the kids to any “specialist” I desired. Yes, it cost money, but no more than $1000 for the whole year and no more than $300 per person. Grant it my Ped books up fast and I need to plan months in advance for well child appointments, but I'll be danged I've never ever had to wait when I've had a sick kid. He always gets us in same day. And we can still use the nearby MTF ER at that fancy new hospital they just built, and were even allowed to use the MTF ortho clinic. Big new building aside, the care seems to be about the same, so we're sticking with standard, and hope that good civilians continue to accept tricare, because a lot don't, and that's the only limiting factor I've found thus far (especially when looking for docs for myself, which I've not been as lucky with).

  6. And, you can put some of your family on Standard, and leave the rest on Prime if you choose to. We're going to at least put me on Standard, since we cannot find a decent PCM that will take Prime.

  7. A tonge tied baby is enough to deal with, one does not need the additional hassle. More then 35 years ago I had a tonge tied failure to thrive baby. In those days no one nursed or delivered babies at home. You know the problem was me and my strange ideas. Even mom and mom in law blamed me. I realize now how blessed I was. We were poor college students in the Chicago area. My doctor sent me to see his friend who not known to me was a famous (at that time) doctor. He saw my son at his home and was so nice to us. After a quick clip and encouragement to continue nursing from this wonderful man things did finally turn around.On a side note he asked us to drive him to a dinner he had to attend at a fancy Chicago Loop hotel. WE drove him to the door. I can imagine what the staff thought as he got out of our beat up old car. We never received a bill from that wonderful man. Hang in there and somehow all will work out. God bless you.

  8. No experience with military insurance here, but I will pipe in to say that I have found that just because something (some entity) says they have a website & online access does not necessarily mean it is fully functional. We've gotten burned a few times this way – assuming that doing things online was actually the way to be effective – but really, not everyone is on board. Grrr.
    I am sorry for your frustrations!

  9. Despite the sadly typical tricare issues, it sounds like you are doing well and comfortable-ish with how George is doing. I'm so grateful to hear that!

  10. Michelle, remember the parking hassles at Walter Reed (and Bethesda)? There were rarely any parking spots, both of us missed appointments that we worked so hard to get because we couldn't find a place to park.

    I recall being asked every single time I called for an OB appointment in Naples (Italy, not Florida), “Are you pregnant?” Well, if I wasn't pregnant, I wouldn't want an OB appointment would I?

  11. THIS is exactly why i have standard. i can't handle that nonsensical garbage.

    its more out of pocket *if* you get sick, have tons of well visits, but if we don't go, you dont pay. so for when i need/want the care, i'm willing to pay the extra.

    because that kind of stuff? CARPITYCARPCARP

  12. I just wanted to ask about the procedure on George. My new baby (also #7)is not nursing well and not gaining weight. The lactation consultant on base recommended getting his tongue and upper lip phrenulum clipped. It is scheduled for tomorrow, but I really don't know what to expect. Were you with him the whole time? How long did it take? Was he able to nurse better right away? Any advice?

  13. Jenny, I don't know about the upper lip, but I imagine it is just like the tongue. The procedure takes seconds. Where I went, the doctor wrapped him in his receiving blanket (tightly) and took him away, down the hall. She came back a few minutes later…I had time to say a Hail Mary and send a text to my girlfriend who had been through the same thing. He was not crying, and she said he only cried for a sec until they picked him up. There was some blood, but not much.

    In my case, he did not nurse well right away because my milk supply was very low to non-existent. If your milk supply is fine, it should be fine right away. If not, get some fenugreek and blessed thistle and start taking it, and start pumping just for the fun of it at least 8 times a day to get your supply up. I used a supplemental system (attached to my breast) to get my baby back on. If your baby is nursing now, you should have no trouble…but less pain and better delivery. I'll pray for you. Let me know how it goes!

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