Proudly Supporting all Military Families with a Special Needs Dependent
You have to hand it to Tricare. They tell you right up front what you’re entitled to as a military family member. The word “adequate” is frequently used to describe our healthcare benefit: “adequate” access to services and “adequate” care to “adequately” meet the family’s needs, just to give a few examples. “Adequate” can be defined as “barely suitable or sufficient” – certainly nothing like the healthcare benefit I imagined.
I haven’t always been so passionate about the healthcare of my family. I haven’t always been concerned about laboratory test coverage, prescription co-pays or compounding, or access to mental healthcare providers. Seven years ago that all changed when we adopted our sons. Our sons, we would discover, would have chronic medical and mental health needs which would need constant monitoring, working with therapists, and necessitating pharmacological assistance. It was then I learned exactly what Tricare had in mind with its repeated mention of adequacy.
From incredibly long wait times to see Primary Care Managers to 6, 8 and even 12 month wait lists to see pediatric specialists, to hours long waits at MTF pharmacies only to be told that the drug you need refilled is currently out of stock to the constant reworking and confounding ABA guidelines, to incredibly limited access to admittedly inadequate mental healthcare professionals – these have been our experiences as a Cat 5 EFM family. On either coast. And, as a family advocate with Military Special Needs Network, I have assisted countless families across the country with similar hardships caused by the Tricare “adequacy” plan, leading me to believe wholeheartedly that this is a systemic problem. A problem, it seems, with a very poor prognosis.
We’re hearing about forced recalls for Tricare Prime enrollees. The thought is that since the War on Terror is over, medical staff will be returning from the frontlines – never mind the mindboggling question of why a developmental pediatrician would be sent to Afghanistan in the first place. That major influx of medical staff will enable our Military Treatment Facilities to now have appointments for the thousands of Prime families who had been farmed out to civilians due to lack of available appointments (see the above mention of 6, 8 and even 12 month waits). Or so they say. Retirees and family members will now be forced to leave their trusted civilian providers in favor of strangers and group care.
We know that against advice from the American Congress of Obstetricians and Gynecologists, Tricare and the DoD brain trust have decided to no longer cover prenatal screening for Cystic Fibrosis.
To better serve their beneficiaries, Tricare has decided to stop their coverage of compounded medicines. Compounded formulas are especially needed for those with allergies to dyes often found in premade meds, for pregnant women, and for children – many with mental healthcare needs.
Civilian providers working at MTFs in certain locations are being pink slipped. For those who have visited their MTFs or tried to get an appointment for a sick child only to be told that they can either see their PCM in 9 days or visit the local MTF Emergency Room, they know that pink slipping any MTF employee is the exact opposite of what is needed.
Now I appreciate the truth in advertising Tricare is displaying, what with all their use of the word “adequate” to describe the truly less than stellar product they have created to reward American servicemembers and their families. I really do. But when was the last time you found yourself saying, “I’d love to take a really adequate vacation!” or “I’d like nothing more than to find an adequate person to fall in love with and raise a family!”
Never. No one ever dreams of adequate. No parent looks for merely adequate healthcare for their children. And no servicemember puts him or herself into harms way, protecting America and her interests for their families to receive “barely suitable” medical care. Our Soldiers, Sailors, Airmen, Marines and Coast Guardsmen fulfill their promise to this country everyday. It’s time for Congress to do the same and #KeepYourPromise.
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A site to discuss and learn about TRICARE Philippines Policies and Issues that are often times implemented in secret by the Defense Health Agency (DHA). Policies that result in payments at about 7.7% and 3.8% of what they should be or $328 per under 65 person instead of the expected $4,261 & $328 per over 65 person instead of the expected $8,650.
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