Total Panic

Chezlee · August 2011

So I just moved home over a month ago. I am 35 weeks pregnant. Daddy is in EOD school so it's just better for me with my family. Plus, I am not too far from the school. Problem is it took tri-care forever to actually assign me a doctor to get a referral. I kept getting people not calling me back or not taking new patients. My PCM is like almost 30 miles from my house. Then they had to find an OB. The only OB is 40 min from my house. They said they didn't know if they wanted to take me. I am freaking out. I keep calling and they keep giving me the run around. We can't afford this baby out of pocket. I don't know if I should be worried or not. I haven't had the Group B test and he was already measuring kind of small when I moved. Is this ok that I haven't seen an OB in so long? I am starting to worry. I keep calling but they can't give me a straight answer, no matter who I ask to speak to. There are no other OBs around here that take Tri-Care Prime.

CravingQueen · August 2011

If you live more than 50 miles from the nearest Military Treatment Facility (i.e. a military clinic or hospital) you should be placed on TriCare Prime-Remote (TPR).

See if you qualify:
https://www.tricare.mil/tpr/default_zip.aspx

Are you calling the TriCare number for your geographical area? For example, if you are on the West Coast, are you calling the TriWest number? I live in WA and when I visited family in MI, TriWest couldn't find me a doctor within 60 miles to see my daughter who had a fever. When I called the TriCare number for the MI region, they found one 5 miles away.

Chezlee · August 2011

Yes, I live 2 hours from the nearest base. That's why they sent me to them. But the thing is no one else here takes Tri-Care Prime. This OB is the worse. It's like just let me be a new patient. They won't unless they see my records and deem me worthy of joining. Like it's some sort of club. That's wrong. I have a baby in need of prenatal care, and was already on the small side when they checked him. I have gained no weight in the last month. I just don't understand this. I am scared that this might hinder him.

NSL · August 2011

Keep calling. If you're worried about your baby, go to the ER. Seriously.

Ilumine · August 2011

Are there any OBs that take TRICARE rei bursement rates period? Ie, go STSNDARD? You just need to ensure that the provide will bill TRICARE for you.

CravingQueen · August 2011

Are you on Prime or Prime-Remote? There is a big difference.

Marion&Kit · August 2011

I'd recommend calling Tricare.

Ask as many questions as you possibly can. If one of their customer service reps says they don't know, ask to speak to someone who would know. Call back multiple times to get multiple different reps, and ask the same questions to see if you get the same information.

It'll take time and effort and I promise it'll be a pain in the butt, but eventually you will get answers.

Chezlee · August 2011

They said Prime. Finally the OB told me my records still haven't been faxed. Why is it taking them this long to figure that out. Now I have to bug my old OB for the records. I just left them a message. So hopefully this goes a lot smoother and quicker.

solomonster · August 2011

You need your husband to call Tricare and tell them that you have moved.. they will move yout o Tricare North or West or East .. I know because thats what i am doing when i move back to chicago in a few months while hubs is on Deployment. I had that problem last yesr when I went home while pregnant.. and now my daughter will be 7 months when we go back for the whole deployment this time.

CravingQueen · August 2011

I wish I could figure it out for you! You need to tell them you've moved and need to be put on Tricare Prime REMOTE

lous22 · August 2011

I switched to Tricare Standard because of similar issues. Its wonderful. Sure, you pay more out of pocket (I have a 150 deductible), but you can pick your own doctors without needing a referral. I've never met a doctor who didn't take it. Its worth the small out of pocket costs!!!

thesuttons53787 · August 2011

We moved to a different state, but same region (Tricare South). We also were switching to the Temporary Tricare insurance b/c DH was just discharged. When filling out the new paperwork, it asked who I wanted to request as my new PCM. I went onto Tricare's website, & looked up providers in my area. The website tells you whether or not they're accepting new patients, and what age range they accept. I was able to do my own research on the facility & the Dr., & tell Tricare who I wanted. I've switched PCM's in the past simply by telling Tricare "This is who I want". Since you're in such a pickle, I agree with a few of the other ladies that you should go Tricare Standard. Come tax season, you can get any extra medical bills & expenses deducted anyway.

Chezlee · August 2011

I can't afford to pay anything out of pocket. Standard is not an option for us. It's a struggle affording our baby. Also, I have switched from North to South. Those are not my issues. The issue is no one takes tri-care out here, except this place, and obviously the Hospital.

emolm · August 2011

Chezlee:
I can't afford to pay anything out of pocket. Standard is not an option for us. It's a struggle affording our baby. Also, I have switched from North to South. Those are not my issues. The issue is no one takes tri-care out here, except this place, and obviously the Hospital.

Have you looked on the Tricare website at all? Have you called Tricare?

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