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Monday, May 17, 2010

Tricare....Spawn of Satan?

Where to even begin....

I enrolled in Tricare Prime last year at Hill Air Force Base. They let me choose my own off-base PCM and I did. I never actually went in and had any appointments or anything, and I didn't really bother changing it when we moved out here, until now.

We live about 10 minutes off post, but we're 15 miles from the hospital (which translates into about 30-45 minutes of driving, depending on traffic, and another 10-15 minutes trying to find a parking place in that God-aweful tea cup they call a parking lot). I went to the Tricare Service Center on base today to change my PCM over from my old Utah doctor to someone here. I had already selected a family practioner within WALKING DISTANCE to our apartment. He had excellent reviews and I wanted him to be both mine and my husbands (and eventually our child's) doctor. And he was accepting new patients. Plus his partner was an ob/gyn so it was like perfect.

Well, Tricare didn't think so. Rather than allow me (and them) the convenience of letting me go to the doctor 30 seconds away from our front door, they assigned me a doctor on base in INTERNAL FREAKING MEDICINE (not even general or gyno), then put me into the Naval Hospital system. Now that I'm in the system, they won't let me out of it!!!

As this was all happening, I asked the lady at the TSC if I could please have a doctor off base...can I fill out one of those Tricare PCM change forms please? She glared at me. "NO!"

So I left the TSC, called Tricare, and asked them how to change my PCM.

"Oh no problem, just fax the PCM change form to us....oh wait're already in the Naval Hospital system. This is out of our control. You're going to have to get them to let you change, since it's now their issue."

So I call the Naval Hospital and ask them what to do.

"No, you have to have a doctor on post because you live within the 30 mile radius."
"But it takes me 30 minutes to get there"
"Yes, but it's in the radius. You can come in to the TSC though and ask them."
"I have to drive 30 minutes back on post to change my doctor to avoid driving 30 minutes on post?"
"Yes, ma'am."

So I call Tricare back and this time go through an entirely different phone tree and get someone different. She looks through her map, asks me zip code, consults the map again...

"Well it looks like you're only 5 miles from post"
"Yes, but it's another 15 or so to the actual hospital. The base is very large"
"Hmm...ok well, I can't really do anything. It's out of my control. You're going to have to go on base to the TSC and petition them."
"Do they have a phone number?"
"Well, call the hospital and have them transfer you though."

So I call BACK to the hospital, explain whats going on, and ask for the TSC.

"They don't have a phone number."
"Oh, they don't? Well I really don't want to have to drive back on post. It's 30 minutes."
"Well, that's not true. They have a phone number. I'm not supposed to tell you this, but if you call Tricare and ask them, they will transfer you to Camp Pendleton TSC." I call Tricare back YET AGAIN, and explain what I was just told. The lady asks me to wait a minute and transfers me through...TO THE PERSON AT THE HOSPITAL I WAS JUST TALKING TO.

I ask her what is going on. She says just give up and come on post. I ask her what exactly are the guidelines to change to a PCM off post and she says that they probably will deny my request because we're only 5 miles from base (plus another 15 from the HOSPITAL...geezus).

So, Tricare....this is what I want to know.

Why, in the name of all things holy, do you have in-network PCM's who accept tricare prime IN FALLBROOK if you won't let anyone actually go there? What do I have to do? What am I missing? Do I have to go and see this "Dr. Vu" I was assigned to and have him refer me to this other guy every 4 visits? Do I have to use standard? Do I have to pretend to move back to Utah, switch to a civilian PCM and then switch BACK to one out here?

Seriously...none of this would have happened had I just ignored everyone's advice and faxed the PCM change form to begin with. But everyone kept telling me I HAD to put myself in the Naval Hospital system. I HAD to go to the JRC and change my PCM with them. I HAD to do that in order to even get a doctor. Come to find out, I could have just faxed the form to the main tricare office with my request and gotten the doctor I wanted to begin with.

Is there a way to get out of the Naval Hospital system or is this like a lifetime without parole kind of situation?

And let me just make myself ABUNDANTLY clear...I DO NOT, under ANY circumstances, want to have a doctor on post. It has nothing to do with the "motrin cures all" mantra (well, maybe a little). It really just has more to do with the nightmare that is that hospital. Getting there is a pain. Parking is an even bigger pain. Finding my way around is a ROYAL pain. And what am I supposed to do about my husband? He can't get in to medical to save his own life. I had to take him to a civilian ER in Salt Lake City when he had freaking pneumonia. I would much rather HE have an off-post civilian doctor as well, because things might actually get done.

I have nothing against Dr. Vu. He is technically a civilian doctor and actually used to work at the medical center in fallbrook that I so desperately wish to go to. I just really wanted to NOT be fucked by the green weenie for once. Is that really to much to ask????

Oh and before I forget....what genius at the Naval Hospital came up with the idea of playing techno rock while you're on hold? The LAST thing I want to hear when I'm about to rip someone a new a-hole is "doooba dooba chicka chooo....dong dong booopbleeeboopbleee dinga choooo"


Amber said...

Ahhh...yes...TRICARE! Need we say more?!?

Yah...once your in the hospital's system, they will NOT let you go, unless the hospital tells them to release you. I had the same thing happen to me with my last pregnancy. I wanted to be seen off of base, the referal went through for me to be seen OFF of base...but then once TCS recieved it, they declined that, and put me on base. I couldn't get out of it. The only answer was to go TCS, and I didn't want to do that. So, base it was!

The only thing I could tell you is to ICE the hospital. Hopefully that might help?!?!

Good luck!!!

Skinnie Piggie said...

Wow, sounds like things are complicated on the west coast... I'm enrolled in Bethesda Naval Hospital (30-45min+ drive). In 10min I can change over to Johns Hopkins via phone/internet. I don't give a crap because I only go to Bethesda 1-2x a year. All of my friends who are pregnant or have severe health issues have switched over, completely uncomplicated, all files changed, and have already had 1-5appts within the last 3mo.

The west coast tricare system should get their act together!

AFwifey said...

Well if you have tricare standard you can choose any doctor or specialist you want... on of off base and dont need referals for anything. From what I read and learned from the people at tricare and a book I read is that tricare prime is better in terms of spending less money but you have more restrictions. Like them choosing your PCM. If I were you I would just deal with the one they give you even if you have to drive a little ways because you spend more for the deductible with tricare standard! :)

The LT's Wifey said...

healthcare as a well is a screwed up entity-tricare is a whole other beast. i hate being treated like a soldier. i'm sorry that is complicated for you. here in hawaii they keep trying to rename me -- either i am my husbands ex-wife or i am still married to my ex-husband. it's great! hang in there!

Marissa said...

Haha I'm sorry but that just cracked me the heck up! You shoulda drove down there and ripped em a new one in person! Seriously, that sucks though. Techno rock is beyond pointless.


tricare always makes me cry, literally.
I just stopped calling them.
I am grateful for 100% coverage though.