Options Needed: I do not want to deliver at the military hospital. — The Bump
Military Families

Options Needed: I do not want to deliver at the military hospital.

So I just had my request for a civilian OB submitted and I found out today that it was denied and that they are sending me to a military OB.  My PCM is a civilian office and would have been in the same building as the OB I requested.  The hospital I would have delivered at would have been right around the corner from my house.

The place I would deliver at would be Portsmouth Naval Hospital in Virginia.  I've heard HORRIBLE things about this place for the majority and a few good experiences that are far and few between.  This is my first pregnancy so naturally this scares me to death.  Besides the horrible care.....and not seeing the same doctor throughout my pregnancy at all, having what I hear is an abundance of rude, inattentive staff that do not listen to you when you are giving birth.....the drive is horrible at certain times of the day.  There is a bridge tunnel that gets backed up with traffic several times a day.  What happens if I go into labor and there is an hour long back up????

I read about patient advocates that can get your doctor changed to a civilian without switching to Tricare Standard.  Is this true?  Anyone know what I am talking about?

 

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Re: Options Needed: I do not want to deliver at the military hospital.

  • I cannot give you advice on switching your OB.  However, if you are stuck in a situation where you are in labor and in traffic you can call 911 and get a police escort to the Naval Hospital.

    Why where you denied your request by TriCare?  Just curious.

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  • image arcook0307:

    I read about patient advocates that can get your doctor changed to a civilian without switching to Tricare Standard.  Is this true?  Anyone know what I am talking about?

    Patient advocates can help you switch doctors. You have t have a very good reason and usually they like specific instances of why you don't want to use the MD they offered. Hearing bad things or having a long drive aren't very good reasons. Also, even though they may allow you to see another dr., you may still have to deliver on post. You should really switch to Tricare Standard.

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  • Switch to Standard.  I had DD1 at Portsmouth and it was fine.  My experience there with DD2 was awful and was completely due to their negligence.  It's a teaching hospital, so there's a good chance you'll get stuck with some moron resident fresh out of med school.  There were way too many people in my L&D room and with the exception of one nurse, they didn't know their @$$es from their elbows.
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  • I guess I can chalk it up to nerves.  I feel very fortunate that I am able to have a baby at no cost to me, however, I have to wonder how good the care is when my nerves allow me to rationalize that I am more of a "number" to these military doctors (some, anyway...not all) than a civilian doctor who would like to protect their reputation a little more.

    I am new to all this so pardon my lack of knowledge.  For the poster that asked why they denied my request, all I can say is that Tricare told me the only way I could see a civilian doctor is if Portsmouth were full....which I guess for OBs they aren't at capacity for patients like they were for a Primary Care Manager (as I mentioned my PCM is a civilian).  I am just learning and figured since I've had all civilian doctors thus far (last year due to location of where we lived) then I just figured I would this time too.  I did my research and found a good doctor and actually stressed quite a bit about that.  Kind of didn't see this coming...

    My husband did say if we go and don't like it he will switch me to standard.  

     

     

     

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  • I have EXTENSIVE experience with crappy military doctors.  I had an AMAZING reason to be seen by a civilian with DS, but the MTF was accepting patients. Therefore, there was nothing I could do.  I was told that I had to be seen at the MTF.  I didn't have enough information about Tricare at the time to know that I could switch.  The care I received was somewhat adequate, and everything turned out okay in the end, though I do believe that the L&D was substandard. (Long story)

    With this pregnancy, I started out at an MTF again.  I really liked the provider that I was seeing.  However, she is a Nurse Practitioner, which means she would not be the one to deliver me.  I wouldn't mee the doctor who would deliver me until the day I went into labor.  In addition, the hospital was 30 miles from my home.  I live 40 miles from DC.  In the morning, it would take me TWO HOURS to get to the hospital.  In the evening, it would take me approx. 45 minutes.  No way. 

    At 24 weeks pregnant, I switched to Standard.  I am SOOO happy that I did.  I love my new OB.  There are four OBs in the practice that I will see, but I will have a chance to meet each of them prior to delivery.  I can actually speak to my OB if I have a problem, instead of having to call the nurse's line at the MTF hospital.  I have more control over the care I receive.  In addition, if I hated my doctor or DS's doctor, I don't have to call Tricare to switch PCMs.  I just call a different doctor in the network.  Sure there is a copay, but it is worth it for the flexibility.

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  • Don't forget that on standard you're covered under global maternity, so it's not like you're going to be forking out a ton of money or anything. And if your husband is E-4 or below there's no lock out period so you can return to prime as soon as you'd like. But, this may end up changing your PCM so I'd think about that.

    I, too, am not thrilled with the MTF I was assigned to. Could not get a referral anywhere else, and actually didn't switch to standard (it would have only helped marginally in my situation anyway and I didn't want to get locked out, especially since I made the decision more than halfway through my pregnancy). For me, quality of care was worth the $4k we've had to pay for this baby.

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  • I would switch to standard. I did that with my second pregnancy and couldn't ahve been happier. Plus I only spent about $20 for the whole prenatal and L&D. Cheap and much better care than I would have gotten at my MTF.
  • I was initially assigned to Langley even though I have an off-base PCM and she requested a civilian OB. I decided to give Langley a shot and at my third appointment I was told that, even though I went to the lab and had blood drawn, my quad screen had not been pulled and that it was now too late to run it. I went to the patient advocate with a completed request for off-base care and was successful in getting referred off-base. I will be staying prime and delivering at a civilian hospital.

    This was my second round of going through the patient advocate to get off-base approval. Both times I have had a reason and both times dealing with the patient advocate has been a long, drawn out process of inefficiency and unreturned phone calls. I was 26 weeks when my request finally got approved and I had trouble finding a civilian doctor to take me so late. I am glad that everything is finally settled but you definitely need to have more of a reason than "I don't want to deliver there" to get referred off-base through the PA office.  

  • Which tunnel are you going to have to go through? Had I stayed with Portsmouth Naval I would not had to deal with any tunnel traffic but chose to switch to Standard and delivery at the Midwifery Center at DePaul in Norfolk. I had to go through the downtown tunnel to get there but really you just plan around it. Knowing what times it generally is backed up you would just need to leave earlier....plus, in my experience many women choose to leave their homes very early in labor so it's not like you'll birth in the car (me on the other hand, arrive pushing to avoid unnecessary interventions).
  • I delivered my youngest in Norfolk and while I could have done the patient advocate thing (I had a doctor at Portsmouth Naval tell me I would need a c-section before I was even pregnant and I just don't do cut happy people), I chose to just switch to Standard.  It was much easier, I got to choose where I delivered (I was at Sentara Leigh and delivered with a midwife and a doula, it was amazing) and paid $25 for the entire thing.

    Having the choice in who provides my care, especially when I'm pregnant, is invaluable to me.  Although I have in the past been able to successfully go through the route of talking to a patient advocate to get referred out in town on Prime (and then it was for my children and only because one of them has asthma and there was no pediatrician on base) it was a lot of work, more than I'm willing to go through again.  Now we're all Standard and life is much easier.

    Mama to three boys Nathan Reese 9.05 Conrad Elijah 5.08 Ezekiel Drake "Zeke" 4.12
  • I'm on standard cause there was no way I would deliver at Portsmouth Naval Hospital, and we only live 10 minutes away from it.  Like the other posters said, global maternity covers pretty much the entire pregnancy and birth, so the only costs you should have is the daily hospital charge of like $18 or something.  Even if it costs more than that, it was well worth it to me to be able to deliver in the hospital I wanted, with the provider I wanted.
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  • Same as everyone else - just switch to Standard. They wanted me to go to West Point to deliver DS. From where I was staying at the time, there is one narrow, windy, mountain road to West Point that closes when there's more than 2 inches of snow. And DS was born in February. I switched to Standard and still payed $0 OOP. 
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  • image MilMom2B:

    Don't forget that on standard you're covered under global maternity, so it's not like you're going to be forking out a ton of money or anything. And if your husband is E-4 or below there's no lock out period so you can return to prime as soon as you'd like. But, this may end up changing your PCM so I'd think about that.

    I, too, am not thrilled with the MTF I was assigned to. Could not get a referral anywhere else, and actually didn't switch to standard (it would have only helped marginally in my situation anyway and I didn't want to get locked out, especially since I made the decision more than halfway through my pregnancy). For me, quality of care was worth the $4k we've had to pay for this baby.

    Holy Cow! You know  pregnancy is covered completely under Standard as well. And the cap to pay out of pocket is 1000/a year so even  if you were to be locked out for a year you would have paid less than HALF of that over the next year. Even if the doctor isn't in the network you would have paid less.

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  • image LemonLover33:
    image MilMom2B:

    Don't forget that on standard you're covered under global maternity, so it's not like you're going to be forking out a ton of money or anything. And if your husband is E-4 or below there's no lock out period so you can return to prime as soon as you'd like. But, this may end up changing your PCM so I'd think about that.

    I, too, am not thrilled with the MTF I was assigned to. Could not get a referral anywhere else, and actually didn't switch to standard (it would have only helped marginally in my situation anyway and I didn't want to get locked out, especially since I made the decision more than halfway through my pregnancy). For me, quality of care was worth the $4k we've had to pay for this baby.

    Holy Cow! You know  pregnancy is covered completely under Standard as well. And the cap to pay out of pocket is 1000/a year so even  if you were to be locked out for a year you would have paid less than HALF of that over the next year. Even if the doctor isn't in the network you would have paid less.

    It's possible she chose a homebirth or a birth center that Tricare would not cover.
  • image ArmyQM:
    image LemonLover33:
    image MilMom2B:

    Don't forget that on standard you're covered under global maternity, so it's not like you're going to be forking out a ton of money or anything. And if your husband is E-4 or below there's no lock out period so you can return to prime as soon as you'd like. But, this may end up changing your PCM so I'd think about that.

    I, too, am not thrilled with the MTF I was assigned to. Could not get a referral anywhere else, and actually didn't switch to standard (it would have only helped marginally in my situation anyway and I didn't want to get locked out, especially since I made the decision more than halfway through my pregnancy). For me, quality of care was worth the $4k we've had to pay for this baby.

    Holy Cow! You know  pregnancy is covered completely under Standard as well. And the cap to pay out of pocket is 1000/a year so even  if you were to be locked out for a year you would have paid less than HALF of that over the next year. Even if the doctor isn't in the network you would have paid less.

    It's possible she chose a homebirth or a birth center that Tricare would not cover.

    I see she did do a home birth. And I think it's been on here before that someone did a home birth on standard for under 2500 ish and still was able to sumbit claims to Tricare. Yet I can't find the thread. But yes, I was quick to judge.

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  • image LemonLover33:
    image ArmyQM:
    image LemonLover33:
    image MilMom2B:

    Don't forget that on standard you're covered under global maternity, so it's not like you're going to be forking out a ton of money or anything. And if your husband is E-4 or below there's no lock out period so you can return to prime as soon as you'd like. But, this may end up changing your PCM so I'd think about that.

    I, too, am not thrilled with the MTF I was assigned to. Could not get a referral anywhere else, and actually didn't switch to standard (it would have only helped marginally in my situation anyway and I didn't want to get locked out, especially since I made the decision more than halfway through my pregnancy). For me, quality of care was worth the $4k we've had to pay for this baby.

    Holy Cow! You know  pregnancy is covered completely under Standard as well. And the cap to pay out of pocket is 1000/a year so even  if you were to be locked out for a year you would have paid less than HALF of that over the next year. Even if the doctor isn't in the network you would have paid less.

    It's possible she chose a homebirth or a birth center that Tricare would not cover.

    I see she did do a home birth. And I think it's been on here before that someone did a home birth on standard for under 2500 ish and still was able to sumbit claims to Tricare. Yet I can't find the thread. But yes, I was quick to judge.

    Yes we are choosing a home birth. There are several other military moms being seen by my midwife. Some of us Standard, some of us Prime. On average Tricare is paying about $2200 for the standard ladies, and $1800 for the prime ones. There are no other options in the area for a home birth or even a birth center so it's not like I could "shop around." As far as the $4k goes, since we don't know for sure that tricare will pay any of it or how much I have just reconciled it in my head that we paid the full amount, if they reimburse us some, then awesome. 

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  • MilMom,

    If you PM me I have a good friend who is a military spouse who has done 3 home births and is a doula herself.  She has done a few of her home births in military housing with 100% Tricare coverage.  If you want me to get in touch (she is a HUGE home birth advocate and a wealth of information) please let me know.  You really shouldn't have to pay that $4,000 and I think that knowing how to navigate the system would be a help :).

    Married 6/28/03

    Kate ~ 7/3/09 *** Connor ~ 11/11/10

    4 miscarriages: 2007, 2009, 2013, 2014

    *~*~*~*~*

    No more TTC for us. We are done, and at peace, as a family of 4.

    "Suffering has been stronger than all other teaching, and has taught me to understand what your heart used to be. I have been bent and broken, but – I hope – into a better shape.” — Charles Dickens

     

  • I'm having the same issues, but out west.  I have a civilian PCM and requested a civilian OB and it got denied even though Balboa Hospital is 30 minutes away . Here's the kicker, My request was put in when I was 5 weeks for an OB, it wasnt til my 8 week mark that I was told it got denied and I have to go to Balboa. Go to Balboa to register and they tell me 1) I didn't need any paperwork filled out before my 1st appointment 2) My first appointment was going to be when they did the first sonogram (I asked if it was an appt my DH should be at) and 3) send me to NTC Point Loma (15 minutes further than Balboa) for said appointment and that the only opening wasn't until I'm over 12 weeks. Today I go in for this appointment and 1) If I hadn't insisted on paperwork to fill out, my appt would've been canceled. 2) there was no ultrasound, I didnt even see an NP or Dr. they only set up my folder. 3) Because my pregnancy is high-risk, I wasn't even supposed to be SEEN at NTC, because all high risks are stuck at Balboa.  Here is the best part: There earliest appointment at Balboa to be seen by a doctor isn't until 7/26 when I'll already be 15 weeks.  At this point I'm ready to rip someone's head off, but I'm scared that if I try to just go with Prime or even use private insurance offered by my job, that it'll take even longer.  I'm not entirely sure what I should do, especially thanks to the horror stories I've heard about Balboa OB care + L&D...I am NOT okay with a ton of people while I'm trying to push a baby out....

    Does anyone have some advice or experience to stop me from crusading against the naval hospital? I've already filed a formal complaint about the blatant misinformation they're giving patients, but am I supposed to trust these people???? :(

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