Tricare Tribulations

Seriously, I could just scream or bust out crying from dealing with this. I hate bureaucracy and I hate inane rules, and Tricare has it all right now.

As with most insurance companies (I’m guessing) you need to select a Primary Care Manager, or PCM. When we last lived here, there was a Tricare clinic less than five minutes from my office, so that’s where I chose my PCM. I did it all online and it was easy peasy. In Michigan, we had a different form of Tricare (called Prime Remote) which basically allowed us to pick “civilian” providers since we weren’t near a Military Treatment Facility (MTF). Again, easy peasy and no issues.

So fast forward to moving back here and needing to pick PCMs again. I should have done it as soon as we got here, but things happen and you know how things slip your mind if you don’t NEED to go to a doctor. But Owen was past due for his 30-month wellness appointment and then I threw my back out, so I figured I had to get it done.

And that’s when the nightmare started.

Actually, it wasn’t a nightmare at first. We wanted to be seen in town (by a Tricare provider) so I searched and yes, the clinic I had gone to was still listed and the pediatrician (that had been recommended to me by a friend) was listed, but I couldn’t seem to access the necessary website to make my selection. Turns out, we had been automatically assigned a PCM so needed a waiver from the Tricare office to change providers/be seen in town, but I was assured (from a friend) that it wouldn’t be an issue and her waiver was granted basically without a second glance. Cool.

So Tom was busy at work (of course) and it took a week or so for him to visit that office to get the form and bring it home for me. I did a website search again to make sure the docs I wanted were still listed, filled out the form along with the reason for my request (base is too far away—30+ minutes usually, and the docs we wanted were 15) and sent it in with Tom.

Aaaaaand, this is where the nightmare actually begins.

I mistakenly put we’re 5 miles from the base (instead of 15—I forgot the 1—maybe I was thinking of the docs we WANTED to go to which are 5 miles away) but when the lady noticed and made a comment about that not being far away, Tom explained that we’re actually 15 miles/30+ minutes away. She agreed we should be going to a doc in town—and was actually stunned that we had been assigned to the base because they’re full. Fine. We’re good to go.

Or so we thought.

Tom got the denial email today saying we’re too close to base (the Naval Hospital is our MTF). What? SERIOUSLY? So Tom called and explained (and rehashed the explanatory conversation he had with the rep when he turned in the form) and oh, THEIR system says we’re 28 minutes from base, and the cutoff is 30, and they don’t count traffic—which of course can add another 20-30 MINUTES if you’re trying to get through the front gate during morning rush hour.

He questioned the decision, and they basically had the attitude of tough shit, it’s mandatory that you’re seen on base, you get what you get, and don’t bother calling again because we’re not going to change it. End of story. She did say that the docs we listed aren’t even in their system—which, WHAT?—I just looked them up three days before! So I told Tom that I’d print out the damn docs off the website and send them in with him as proof—but guess what? The entire site has been redesigned and the stuff I found last week is no longer there. OF COURSE. Searching for providers in our area brings up NOTHING because it’s apparently now MANDATORY that we are seen on base. >:XX

So I call the main Tricare people (Health Net Federal Services), and long story short, she tells me since we’re right on the cusp (28 minutes vs. 30 minutes) they really should give us the waiver, but it IS up to the individual office…and that we need to call that office and ask how to file an appeal. Yeah, it sounds good, but with the severe attitude Tom got when he called, I don’t see an appeal going over well. And he wasn’t exactly in an agreeable mood.

Yes, I know I should be happy that we even have insurance—and I get that. But it really should be easier than this.

So THEN I figured well, Owen needs his appointment and I will need more meds soon (for my back) so I guess I’ll just suck it up and make an appointment for both of us while we figure out if we can appeal the waiver. I know you can make appointments online, but I couldn’t login—and had no idea why.

Which started an avalanche of frustration about all the >:XX Tricare and Tricare-related websites. I know for a fact I’ve registered on these sites, but my logins aren’t working and you can’t just request your password be sent or even reset—since it’s medical stuff with extreme privacy laws, you have to request a reset and expect a security code in the mail within 10 days. Oh, and all three of us can’t be on the same account on one site—everyone over 18 has to have their own account. So Owen is under Tom’s, and I have my own—WHICH I KNOW I >:XX SET UP but they seem to think all my information is invalid and can’t find me…but if I try to register again, it tells me I already have an account. And another site, in order to get a login, I either need a DOD access card or a MyPay account (which I used to have Tom’s login until their changed their requirements and now it’s some unintelligible and random string of gibberish that I can apparently never type in correctly) or I can request my own login, but in order to request that login, you need one of the aforementioned types of logins…that I can’t get because I don’t have the login?!?!?

>:XX :crazy: :## :down:

So yes I can actually make a phone call to get an appointment, but by the time I had dealt with all that >:XX nonsense, I was done. D. O. N. E. DONE.

I can deal with a lot of stuff rationally (believe it or not), but this shit just drives me >:XX bonkers.