Military Brides

MOST important TRICARE information-Access to Care!!!!!

This was brought up in my pp and was always an issue when I was working.  ACCESS TO CARE.

By Policy, you (the beneficiary) have a Standard ACCESS to CARE policy.  

In general, access standards for care include:

  • The wait time for an urgent care appointment should not exceed 24 hours (one day).
  • The wait time for a routine appointment should not exceed one week (seven days).
  • The wait time for a specialty care appointment or wellness visit should not exceed four weeks (28 days).

If you are not provided an appointment or referral for an appointment within these standards YOU MUST DEMAND IT. IF the TRICARE Service Center does not help you, then you take the complaint to both the MTF Patient Advocate AND Contact your Managed Care Contractor (regional contractor who manages the civllian network) and DEMAND an APPOINTMENT. And if THAT does not work you contact your DH's Shirt and make a fucking stink.

The reality is, TRICARE is short docs (since many are down range) and about 6 years ago, there was a push to cut the number of military docs down - they thought it would be cheaper to go civilian then pay retirement pays...but its not - hence trying to keep the dependents IN house and not referr downtown). So they will try to push off non-urgent specialty care to keep it on base.

HOWEVER, you HAVE A RIGHT TO BE REFERRED OFF BASE IF THEY CANNOT SEE YOU WITHIN 28 days. (some bases will fight you and say that is 30...who cares about 2 measly days). 

So - DO NOT LET THEM RAILROAD YOU.  Yes you CAN go over the head of the appt setters or first level referral setters.  Yes you CAN go to your husband's SHIRT (an unhappy or unhealthy spouse makes an unproductive servicemember). 

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Re: MOST important TRICARE information-Access to Care!!!!!

  • IlumineIlumine member
    Ninth Anniversary 10 Comments 5 Love Its Combo Breaker
    edited December 2011
    Sorry - here is the link to the TRICARE WEBSITE that covers their ACCESS TO CARE POLICY. SO if anyone gives you a problem, provide them with their own damn link.

    http://www.tricare.mil/mybenefit/Glossary.do?F=a
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  • ggirl2001ggirl2001 member
    Ninth Anniversary 2500 Comments 5 Love Its Combo Breaker
    edited December 2011
    llumine-I think i might be sending you  a PM. I'm getting married in August. Just astarted a new state job in SC and am trying to decide what will be the best choice for me for insurance (meaning to keep my state insurance or go with tricare, or add tricare as a second insurance, etc)
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