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Yet another Tricare Question...

BabyCampbell312BabyCampbell312 member
in Military Families

Sorry for another one of these but .....

With my first pregnancy I originally started out on Prime. I called my PCM and told her I was preg and she sent Tricare the referral/auth. 

Then Tricare wanted me to go to a MTF. I didn't want to go and wanted to pick my own doctor. I switched to standard and then went to a doctor that accepted Tricare Standard. 

Maybe it's been a while, but when I called Tricare the other day about this, asking if I can just switch to standard and go to who I want, they said, "No, even if you are on standard you will have to see if the MTF will take you first. You can ask to be released but who knows if you will be."

 

Can anyone shed any light on this?

TIA for your feedback!

 

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Re: Yet another Tricare Question...

  • meltoinemeltoine member
    The Tricare rep you talked to is mistaken. You can see any network provider you want. 
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  • ehnastoehnasto member
    I'm Tricare Prime, but when I found out I was pregnant and went to see my PCM (they make me physically see them here) I told her who I wanted to go see. She was rather accommodating. I know sometimes if you leave it up to Tricare they can be a bit of a butt, but if you talk to your PCM they may be willing to change your referral directly to the OB you want (if they are in network).
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  • LyndseylovesHughLyndseylovesHugh member

    imagemeltoine:
    The Tricare rep you talked to is mistaken. You can see any network provider you want. 

    This. I switched to standard and did not need to go to a mtf nor did I need as referral. 

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  • Lissa832Lissa832 member
    In my experience, you should always call three separate times asking the same question. Best 2 out of 3 wins, lol. Standard offers flexibility, which is its draw. You don't have to be seen at an MTF, but you can be if there is space. You can choose any doctor you'd like.
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  • JENandJEHJENandJEH member
    imageMommyLizzy:

    imageehnasto:
    I'm Tricare Prime, but when I found out I was pregnant and went to see my PCM (they make me physically see them here) I told her who I wanted to go see. She was rather accommodating. I know sometimes if you leave it up to Tricare they can be a bit of a butt, but if you talk to your PCM they may be willing to change your referral directly to the OB you want (if they are in network).

    This has been my experience too, I don't know why so many women feel the need to switch to standard during pregnancy.  Getting a referral off post is very easy to do. Especially since most installations have too many pregnant woman being treated on post and space is a huge issue.

    I never talk to tricare about my referrals they are mostly all idiots.  Always talk to your doctor. 

    Where we are stationed, the only way you get referred off post for OB care is if you are considered high risk and even then, they will sometimes not refer off even if your PCM submits the referral for a civilian provider.  So, while it's awesome that your doc was able to submit that and it was approved for you, at some installations it's not that easy.  My initial referral for an off post OB by my off post PCM was denied as was a second one that my PCM submitted due to a continuity of care issue. 

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  • ehnastoehnasto member

    I'm at Robins AFB.  I have found that if I am having a problem and actually physically go to the Tricare office the people there have taken awesome care of me and will call the Tricare "phone people" and fuss at them for me. If I call Tricare they seem like they have no idea what they are doing.

     

    Good luck. 

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  • zonagirliezonagirlie member
    I'm Prime and I've never seen a dr. on post. Ever. I am assigned to a PCM, but I don't see her. Only my OB/MW. Never had an issue with it since I got on Tricare.
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  • inateapotinateapot

    Our last base you absolutely had to switch to standard to be seen off base. Even high risk, they saw you at the MTF. They had just built a big new birthing center at the hospital & so they had to fill it. *shrug* HOWEVER, once I switched to standard, they had to release me when I requested a diff. provider. They didn't like it, but they did.

    At our current location, Tinker AFB, they don't have a MTF for OB care. Everyone is referred off base. I just had my kiddo in a lovely hospital and it went super smoothly. 

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