Sagewood Country

Welcome to Sagewood Country! Crafts, Gardens, Challenges and much more. Come visit and say HI!
 
HomeFAQSearchMemberlistUsergroupsRegisterLog in

Share | 
 

 So I'm trying to decide...

Go down 
AuthorMessage
LeaShi

avatar

Number of posts : 485
Age : 35
Location : New York
Registration date : 2008-04-08

PostSubject: So I'm trying to decide...   Wed Jun 25, 2008 8:40 pm

...if I wanna wage war on Tricare. I'm not gonna go into a lot of detail, but I found out (through a series of phone calls that lead to a bunch of frustration) that the hospital closest to my home isn't on Tricare's list of approved facilities. What this means is, unless I want to pay out the ass, I can't deliver my baby there like I was planning. The nearest hospital I where I could be admitted and not have to pay is nearly an hour away in Saratoga. This isn't a problem per se, but it is a lot less convenient than having the baby at the nearby hospital in Johnstown.

So I'm trying to make up my mind here. I could try to get a waiver from Tricare that would allow me to have my baby where I want - this may or may not get approved. The pros of having the waiver approved would be:

  • Twenty minute drive vs. forty-eight minute drive.
  • If I ended up having to drive myself to the hospital (possibly in inclement weather since I'm due in November), I'll have a shorter distance to go and could give myself more time to get there if I needed it.
  • It would give Niel more time to get home were I to go into labor while he was at work.
  • Niel would have to spend less time away from me and the baby to do things like feed the dogs and let them out.
  • My OB's office is located in the hospital, so it would be easier for him to get to me if there were an emergency where he was needed.
  • This hospital is offering birthing classes that include tours of the facilities and a chance to preregister. (The other hospital may offer this as well, but see comment about gas prices.)
  • Once my baby and I are released, the trip home would be shorter, so we could get settled in faster (not a requirement, but definitely nice).
  • Gas prices are over $4.20 a gallon here, so the fewer miles I drive for anything at all, the better.

Sounds great, right? Well, it would be nice, but there's also a very good chance that Tricare will decline my waiver, so I'd be stuck in the same boat I'm in now. The main reason I haven't called up Tricare already about this is I hate dealing with them. Here's why:

  • Whenever I call, I never get the same answers. One representative will tell you one thing, while another representative will tell you something completely different.
  • None of the representatives seem to actually care whether they've fixed the problem you're calling about, they only seem to want you off the phone as quickly as possible.
  • The representatives don't seem to care about me or my health.
  • The list of approved providers is extremely limited, and it is very rarely that you can actually get the provider you request. Sometimes I wonder if they even look at the request forms before they assign you to someone.
  • Beneficiaries themselves have very little control over how their health is handled. To get any real results, you need an advocate. Good luck finding one though.
  • The approval process is so slow that if you're diagnosed with a terminal illness, you'd be better off calling a funeral parlor than Tricare.

I know the list of cons is shorter, but truly I'm wondering if the trade off is really worth it. I get so frustrated with Tricare that I'm thinking life would just be easier if I sucked it up and made the longer drive to the Saratoga hospital. I've got a little while to think on it, but if I decide to try for the waiver, the sooner I start the process, the better. What do you guys think?

_________________
My best friend is non-verbal, incontinent, and rough on cats:
https://s740.photobucket.com/albums/xx49/ciannons_fan_page/

www.AshleysCrescentMoon.etsy.com
Back to top Go down
View user profile http://www.AshleysCrescentMoon.etsy.com
MandaMae

avatar

Number of posts : 146
Age : 34
Location : Fort Frozen Hell, NY
Registration date : 2008-05-07

PostSubject: Re: So I'm trying to decide...   Thu Jun 26, 2008 12:45 am

Well having dealt with the loverly Tricare myself.... FIGHT LIKE HELL! Raise hell file forms and generally make everyone you deal with there MISERABLE. They made me see this bastard of a doctor and trust me you don't want someone you don't like delivering your kid. You're going to get more emotional and more easily upset as time goes on (yay hormones Neutral ) So go ahead and start the process so you don't end up in the situation later on where you're upset and stressed when you can possibly prevent it. Give it a shot at least. and Chew some butt for me too LOL
Back to top Go down
View user profile http://www.myspace.com/mistressangel1983
Lightfoot
Admin
avatar

Number of posts : 451
Age : 57
Location : is everything
Registration date : 2008-04-23

PostSubject: Re: So I'm trying to decide...   Thu Jun 26, 2008 9:28 am

It is aggravating dealing with insurance companies! Good luck, whatever you decide to do.

_________________
"Live your life in such a way that when your feet hit the floor in the morning, Satan shudders & says...'Oh shit....she's awake!!"
Back to top Go down
View user profile
LeaShi

avatar

Number of posts : 485
Age : 35
Location : New York
Registration date : 2008-04-08

PostSubject: Re: So I'm trying to decide...   Thu Jun 26, 2008 1:31 pm

Ya know, Manda, I see your point, but sometimes I think my vendetta with them would be better solved by a flame-thrower than by filing a claim. lol!

I still haven't decided what I'm going to do. Niel says it's up to me. ::Sigh:: He never was much help in the decision making department, lol.

_________________
My best friend is non-verbal, incontinent, and rough on cats:
https://s740.photobucket.com/albums/xx49/ciannons_fan_page/

www.AshleysCrescentMoon.etsy.com
Back to top Go down
View user profile http://www.AshleysCrescentMoon.etsy.com
LeaShi

avatar

Number of posts : 485
Age : 35
Location : New York
Registration date : 2008-04-08

PostSubject: Re: So I'm trying to decide...   Mon Jul 21, 2008 3:42 pm

Well, I did it. Today I called my PCM and told them I wanted to submit a referral to deliver at the hospital closest to my home. I did this after I found out straight from the horse's (or doctor's) mouth that he doesn't have doctor privileges at the hospital Tricare wants to send me to. I told him, "Well, the Tricare representative told me that you deliver there all the time." His response was, "That Tricare represenative doesn't know what she's talking about." When I called today, I explained to the receptionist at my PCM's office why I wanted the referral submitted, and she said, "Well they shouldn't be sending you to a hospital he can't go to." As if I don't already know this. At any rate, she said they'd get right on it, so hopefully I'll be hearing something in the next few weeks. Hopefully it won't be too late to sign up for the birthing classes the hospital offers when I get my approval letter. Keep your fingers crossed for me!

_________________
My best friend is non-verbal, incontinent, and rough on cats:
https://s740.photobucket.com/albums/xx49/ciannons_fan_page/

www.AshleysCrescentMoon.etsy.com
Back to top Go down
View user profile http://www.AshleysCrescentMoon.etsy.com
Lightfoot
Admin
avatar

Number of posts : 451
Age : 57
Location : is everything
Registration date : 2008-04-23

PostSubject: Re: So I'm trying to decide...   Tue Jul 22, 2008 3:07 am

Good Luck!

_________________
"Live your life in such a way that when your feet hit the floor in the morning, Satan shudders & says...'Oh shit....she's awake!!"
Back to top Go down
View user profile
LeaShi

avatar

Number of posts : 485
Age : 35
Location : New York
Registration date : 2008-04-08

PostSubject: Re: So I'm trying to decide...   Tue Jul 22, 2008 2:06 pm

HOORAY!!!! My referral was approved! My PCM even got the name and number of the person who told her it could happen, so now I can hold somebody responsible in the event Tricare tries to back peddle. YAY!

_________________
My best friend is non-verbal, incontinent, and rough on cats:
https://s740.photobucket.com/albums/xx49/ciannons_fan_page/

www.AshleysCrescentMoon.etsy.com
Back to top Go down
View user profile http://www.AshleysCrescentMoon.etsy.com
Lightfoot
Admin
avatar

Number of posts : 451
Age : 57
Location : is everything
Registration date : 2008-04-23

PostSubject: Re: So I'm trying to decide...   Wed Jul 23, 2008 11:08 am

Very Happy Congrats! It's nice when things work like you want them to.

_________________
"Live your life in such a way that when your feet hit the floor in the morning, Satan shudders & says...'Oh shit....she's awake!!"
Back to top Go down
View user profile
Sage
Admin


Number of posts : 316
Age : 57
Location : South Carolina
Registration date : 2008-04-08

PostSubject: Re: So I'm trying to decide...   Thu Jul 24, 2008 3:21 pm

WAY TO GO GIRLY!!!!!

_________________
May those who love us love us,
and those who do not love us,
may God turn their hearts,
and if He cannot turn their hearts
may He turn their ankles
that we may know them by their limping.

~Irish Prayer

http://sagewoodfarm.blogspot.com/
Back to top Go down
View user profile http://sagewoodfarm.blogspot.com/
Sponsored content




PostSubject: Re: So I'm trying to decide...   

Back to top Go down
 
So I'm trying to decide...
Back to top 
Page 1 of 1
 Similar topics
-
» Trying to decide on a front for Weeping Red Pine; which side is better?
» T&T Tube Fenders
» You Get to Decide: Deck Master Forbidden List!

Permissions in this forum:You cannot reply to topics in this forum
Sagewood Country :: Bits and Pieces :: Pandora's Box-
Jump to: