Am I going to have to deal with this again(tricare)? — The Bump
Military Families

Am I going to have to deal with this again(tricare)?

so, I just got a new referral from my doctor for my fertility clinic, I've been seeing them for over a year now, and we have one last appointment before he wants to release me to the OBs, but he needed a new referral since the one he had was expired I guess, and I got a call from the naval medical center saying they want to see me in their fertility clinic, I guess I have to jump through some hoops and get them to release me, but I also want to see a civilian OB, are they going to make me jump through hoops for that?
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Re: Am I going to have to deal with this again(tricare)?

  • They want to see you in their fertility clinic instead of giving you a new referral to the one you're already being seen at?
    If that's the case then I would could the patient advocate and explain that you'd prefer to have continuitty of care with your current provider. They should approve that.
    As for a civilian OB,  you can ask the patient advocate about that too, but your best bet is probably to switch to Standard. Any care related to the pregnancy will be covered 100% (as long as its a regularly covered procedure or visit) but if you break your leg or something, you will pay a cost share for care unrelated to the pregnancy. You can switch back to prime after the pregnancy.  
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  • yeah, well, they said continuity of care isn't within my rights, which is bullshop.... but, whatever, I think what happened was that the fertility referral got duplicated and one got denied and sent to the naval hospital.

    I'm gonna see my fertility doctor to confirm the pregnancy and make sure there aren't mutiples or anything special, then I'm going to try to go to the OB in the same office that I've been seeing, but if not I'll switch to standard and pay the $25 global maternity care thing. 

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  • Tricare is right. If your prime and a pregnancy has resulted, you will be treated no different than an other prime member. You don't get to just choose your OB because it's convenient. You get to do as you are told. That is the beauty of standard.
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  • Have fun with the copays. Even if pregnancy is covered, not everything else is. My SIL kept complaining when she had a huge bill after my nephew's surgery. Keep that in mind before you switch. I have a great military OB and don't understand why people aren't grateful for the wonderful coverage provided to us. 
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