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Posted: 2/17/2006 4:30:11 PM EDT
For 9 months last year I was on ADSW orders.

9 months broken by 2 weeks of AT. But because my orders ended and were renewed I NEVER became eligible for Tri-Care (.mil healthcare). Or so I believed.

Today I received in the mail a letter of certification from Tri-Care stating that I was eligible for services from Dec. 22, 05, through Jan 27, 06.

And they are just now getting around to telling me!!!!


Bloody hell, I have needed to go to the doctor since the beginning of Dec. and put it off because I was unemployed. I went off orders after Hurricane Katrina on Nov. 3rd.

I work my ASS OFF for the .mil for a FREAKIN' year and they give me ONE bloody MONTH of coverage and don't bother to TELL me until three WEEKS after it ENDS.



/rant off
Link Posted: 2/17/2006 4:32:00 PM EDT
Link Posted: 2/17/2006 4:34:43 PM EDT
Sorry to hear that. But we are talking about the federal gov't. They could fuck up a wet dream.
Link Posted: 2/17/2006 4:37:32 PM EDT

Originally Posted By C-4:
Sorry to hear that. But we are talking about the federal gov't. They could fuck up a wet dream.




After the time I have spent with them they have done that more than once.
Link Posted: 2/17/2006 4:44:27 PM EDT
Link Posted: 2/17/2006 4:46:13 PM EDT
[Last Edit: 2/17/2006 4:47:08 PM EDT by Hydguy]

Originally Posted By Sylvan:
My 4 year old daughter just broke her arm.
The military hospital is closed for the 4 day weekend and none of the local clinics take tri-care.
Poor little critter has to wait till Tuesday to get her cast, I am TDY 3 time zones away and my wife is stuck with the 3 kids.
Frustrating.
More to the point, tricare isn't bad, but it certainly isn't the best.



Can't she just walk into an ER? She cannot be denied service.

BTW, the military hospital never shuts down. The ER on base is ALWAYS open.
Link Posted: 2/17/2006 4:51:54 PM EDT

Originally Posted By Sylvan:
My 4 year old daughter just broke her arm.
The military hospital is closed for the 4 day weekend and none of the local clinics take tri-care.
Poor little critter has to wait till Tuesday to get her cast, I am TDY 3 time zones away and my wife is stuck with the 3 kids.
Frustrating.
More to the point, tricare isn't bad, but it certainly isn't the best.




You CANNOT wait that long for a cast. IT IS NOT POSSIBLE. Go ANYWHERE to get the job done, trust me. This will screw up your daughter's arm for the long-term if it is not taken care of.

(yes, it can be fixed but is more pain and suffering than she deserves)
Link Posted: 2/17/2006 4:56:44 PM EDT
Link Posted: 2/17/2006 4:57:19 PM EDT
Link Posted: 2/17/2006 4:59:21 PM EDT
Link Posted: 2/17/2006 5:00:47 PM EDT

Originally Posted By Sylvan:
My 4 year old daughter just broke her arm.
The military hospital is closed for the 4 day weekend and none of the local clinics take tri-care.
Poor little critter has to wait till Tuesday to get her cast, I am TDY 3 time zones away and my wife is stuck with the 3 kids.
Frustrating.
More to the point, tricare isn't bad, but it certainly isn't the best.


Tri-care will pay for emergency service at any ER. Take her in NOW. Yes you will have to jump through hoops, but it will get done. We have to do it all the time around here.



Emergency Care
All TRICARE beneficiaries, in the event of a life-, limb-, or eyesight-threatening emergency, should call 911 or go to the nearest emergency department for care. If enrolled in TRICARE Prime, in all emergency situations, you must notify your Primary Care Manager (PCM) or regional contractor within 24 hours of any emergency admission so that ongoing care and claims processing can be coordinated.


And here:

For emergencies, go to the nearest emergency room, military or civilian. In a civilian setting, after your care and before you go home, identify yourself as a TRICARE Prime enrollee, and give this address to use for filing the claim:

Health Net Federal Services c/o PGBA
LLC/TRICARE, P.O. Box 870141,
Surfside Beach, SC 29587-9741

Request a copy of the bill for your records, and expect to receive in the mail an Explanation of Benefits from TRICARE showing payment of the bill. If more than six weeks go by, and you have not received an EOB, call the civilian facility and ensure they have filed the claim and to the proper address. If they have, take your copy of the bill to a TRICARE Service Center and ask a Health Benefits Advisor to assist you.

For urgent care situations, coordinate with your PCM or with Health Net, 1-877-TRICARE, for care authorization. Care that is not authorized before it is received may be covered under TRICARE Prime Point of Service.




Even if they wouldn't pay, I can't imagine a parent letting a child go for four days with no cast.

Link Posted: 2/17/2006 5:01:26 PM EDT
Link Posted: 2/17/2006 5:05:15 PM EDT
$35 co-pay for ER visits, trust me, I know
Link Posted: 2/17/2006 5:06:57 PM EDT
[Last Edit: 2/17/2006 5:09:59 PM EDT by Sylvan]
Link Posted: 2/17/2006 5:10:33 PM EDT

Originally Posted By Hydguy:

Originally Posted By Sylvan:
My 4 year old daughter just broke her arm.
The military hospital is closed for the 4 day weekend and none of the local clinics take tri-care.
Poor little critter has to wait till Tuesday to get her cast, I am TDY 3 time zones away and my wife is stuck with the 3 kids.
Frustrating.
More to the point, tricare isn't bad, but it certainly isn't the best.



Can't she just walk into an ER? She cannot be denied service.

BTW, the military hospital never shuts down. The ER on base is ALWAYS open.




Sure...tell the guys up here at Eielson that...they'll laugh at you.


Take her to the ER. I had to go once when I was home on leave and everything was taken care of. They rolled the cast in the ER by the way.
Link Posted: 2/17/2006 5:10:36 PM EDT

Originally Posted By Sylvan:
Just got done talking to the wife.
The wrist was compacted (buckled) and she now has a formed splint. The military nurse said that they can't cast till Monday due to swelling, anyway. No problem paying the money, but the wife says she is comfortable with the immobilization and there is no resetting required.


Now that makes some sense.
Whew. The though of a little girl with a broken arm and no cast had me really worked up.
Link Posted: 2/17/2006 5:25:40 PM EDT

Originally Posted By sledhead907:

Originally Posted By Hydguy:

Originally Posted By Sylvan:
My 4 year old daughter just broke her arm.
The military hospital is closed for the 4 day weekend and none of the local clinics take tri-care.
Poor little critter has to wait till Tuesday to get her cast, I am TDY 3 time zones away and my wife is stuck with the 3 kids.
Frustrating.
More to the point, tricare isn't bad, but it certainly isn't the best.



Can't she just walk into an ER? She cannot be denied service.

BTW, the military hospital never shuts down. The ER on base is ALWAYS open.




Sure...tell the guys up here at Eielson that...they'll laugh at you. Is it an AD base, or a reserve base? AD, it will be open 24/7/52/365. Reserve, I guess it would only be open during drill.


Take her to the ER. I had to go once when I was home on leave and everything was taken care of. They rolled the cast in the ER by the way.

Link Posted: 2/17/2006 5:27:49 PM EDT
Any orders greater than 30 days you and your family (spouse and kids) are eligible.
Link Posted: 2/18/2006 4:31:32 AM EDT

Originally Posted By STLRN:
Any orders greater than 30 days you and your family (spouse and kids) are eligible.




Tell that to Tri-care. I had orders longer than 30 days 4 times last year and got only 30 days of eligibility that they did not bother mentioning.
Link Posted: 2/18/2006 5:37:34 AM EDT

Originally Posted By Jame_Retief:

Originally Posted By STLRN:
Any orders greater than 30 days you and your family (spouse and kids) are eligible.




Tell that to Tri-care. I had orders longer than 30 days 4 times last year and got only 30 days of eligibility that they did not bother mentioning.



I use to be the equivalent of your services AC/RC, we had to deal with this all the time, Tricare begins with orders for 30 days or more, just like BAH I starts if you have orders for 6 months or more, vice BAH type II. But the bottom line is at a certain point it is your responsibility to look into things or ask questions.
Link Posted: 2/18/2006 8:06:32 AM EDT
[Last Edit: 2/18/2006 8:09:06 AM EDT by PeteCO]

Originally Posted By Sylvan:
My 4 year old daughter just broke her arm.
The military hospital is closed for the 4 day weekend and none of the local clinics take tri-care.
Poor little critter has to wait till Tuesday to get her cast, I am TDY 3 time zones away and my wife is stuck with the 3 kids.
Frustrating.
More to the point, tricare isn't bad, but it certainly isn't the best.



Uh, WTF? You are making her wait three days with a broken fucking arm?!?!? Wow.

There are these things called Emergency Rooms. You might try one.

ETA: Saw your post about the splint. Good. I was beginning to think you were the biggest fucking idiot I had ever seen on Arfcom.
Link Posted: 2/18/2006 8:10:03 AM EDT
Link Posted: 2/18/2006 8:14:46 AM EDT

Originally Posted By PeteCO:

Originally Posted By Sylvan:
My 4 year old daughter just broke her arm.
The military hospital is closed for the 4 day weekend and none of the local clinics take tri-care.
Poor little critter has to wait till Tuesday to get her cast, I am TDY 3 time zones away and my wife is stuck with the 3 kids.
Frustrating.
More to the point, tricare isn't bad, but it certainly isn't the best.



Uh, WTF? You are making her wait three days with a broken fucking arm?!?!? Wow.

There are these things called Emergency Rooms. You might try one.

ETA: Saw your post about the splint. Good. I was beginning to think you were the biggest fucking idiot I had ever seen on Arfcom.



You're a fucking idiot for not reading more of the thread. Why rip on the guy without knowing the hwole story?
Link Posted: 2/18/2006 8:24:20 AM EDT
[Last Edit: 2/18/2006 8:25:49 AM EDT by PeteCO]

Originally Posted By Dace:

Originally Posted By PeteCO:

Originally Posted By Sylvan:
My 4 year old daughter just broke her arm.
The military hospital is closed for the 4 day weekend and none of the local clinics take tri-care.
Poor little critter has to wait till Tuesday to get her cast, I am TDY 3 time zones away and my wife is stuck with the 3 kids.
Frustrating.
More to the point, tricare isn't bad, but it certainly isn't the best.



Uh, WTF? You are making her wait three days with a broken fucking arm?!?!? Wow.

There are these things called Emergency Rooms. You might try one.

ETA: Saw your post about the splint. Good. I was beginning to think you were the biggest fucking idiot I had ever seen on Arfcom.



You're a fucking idiot for not reading more of the thread. Why rip on the guy without knowing the hwole story?



Go fuck yourself. I didn't ask your opinion, sport. And presumably, when someone posts, it IS "the whole story". He only had to add to his story because it was initially incomplete, yes?

Link Posted: 2/18/2006 8:28:53 AM EDT

Originally Posted By STLRN:

Originally Posted By Jame_Retief:

Originally Posted By STLRN:
Any orders greater than 30 days you and your family (spouse and kids) are eligible.




Tell that to Tri-care. I had orders longer than 30 days 4 times last year and got only 30 days of eligibility that they did not bother mentioning.



I use to be the equivalent of your services AC/RC, we had to deal with this all the time, Tricare begins with orders for 30 days or more, just like BAH I starts if you have orders for 6 months or more, vice BAH type II. But the bottom line is at a certain point it is your responsibility to look into things or ask questions.




I have looked into it a number of times. Applied for coverage as they state that you need to do. Got Zero response my application and was rejected for any request for payment. Do you happen to know WHERE to look for the information? Because no one here could point me to where that information was.
Link Posted: 2/18/2006 8:42:35 AM EDT
Link Posted: 2/18/2006 8:55:56 AM EDT

Originally Posted By Sylvan:

Originally Posted By PeteCO:

Originally Posted By Dace:

Originally Posted By PeteCO:

Originally Posted By Sylvan:
My 4 year old daughter just broke her arm.
The military hospital is closed for the 4 day weekend and none of the local clinics take tri-care.
Poor little critter has to wait till Tuesday to get her cast, I am TDY 3 time zones away and my wife is stuck with the 3 kids.
Frustrating.
More to the point, tricare isn't bad, but it certainly isn't the best.



Uh, WTF? You are making her wait three days with a broken fucking arm?!?!? Wow.

There are these things called Emergency Rooms. You might try one.

ETA: Saw your post about the splint. Good. I was beginning to think you were the biggest fucking idiot I had ever seen on Arfcom.



You're a fucking idiot for not reading more of the thread. Why rip on the guy without knowing the hwole story?



Go fuck yourself. I didn't ask your opinion, sport. And presumably, when someone posts, it IS "the whole story". He only had to add to his story because it was initially incomplete, yes?



hey,
I found out about 10 minutes before posting.
I am in Missouri.
My daughter is in Alaska.
But I am a pretty big fucking idiot.
Just for different reasons.



No problem, I was confused by your first post.

What's scary is that I DO know of people who are so mistrusting of "those dern high-priced docters and thur high-fallutin medikul toys" that they would rather do nothing, or worse, try to fix it themselves.

I also know of one idiot who stitched his own son's arm undoubtedly because he thought it would be cool to use some of that emergency gear he had stockpiled. He has NO training - he's a machinist. He could have fucked his kid up bigtime with improper technique, not to mention that he did this to the kid with nothing to lessen the pain. I don't talk to him anymore, for various reasons.

Link Posted: 2/18/2006 9:07:32 AM EDT

Originally Posted By Jame_Retief:
For 9 months last year I was on ADSW orders.

9 months broken by 2 weeks of AT. But because my orders ended and were renewed I NEVER became eligible for Tri-Care (.mil healthcare). Or so I believed.

Today I received in the mail a letter of certification from Tri-Care stating that I was eligible for services from Dec. 22, 05, through Jan 27, 06.




Sounds like typical tricare screwup. BTW, they owe you a DD214 for every ADSW period, and they owe you terminal leave at the end of each ADSW period (2.5 days a month). So, if your ADSW was for 3-4 months, not only were you covered by Tricare (if you had gotten an Active Duty ID card that might have made the process easier), but you also should have been on terminal leave before your AT. Or you could have chosen to cash you leave out when you outprocessed at the end of you ADSW.

Let me guess...you never got any leave, you never actually outprocessed, and you never got a 214.

Link Posted: 2/18/2006 10:03:00 AM EDT
I'm only speaking for the Air Force...the majority of Air Force bases have military clinics, not full-up hospitals. In most cases, the clinics do not maintain a 24/7, 365 day a year ER. During duty hours you can go to the clinic. After duty hours you have to go down town. In military towns there is usually a relationship with the local civilian hospital.
Link Posted: 2/18/2006 11:56:47 AM EDT
30 seconds of Google Tricare Reserve programs.


Reserve Component Members
When on military duty, RC members are covered for any injury, illness or disease incurred or aggravated in the line of duty, including traveling to and from military duty, under line-of-duty procedures. Medical coverage (direct care at the MTF) is available when the member is activated. When ordered to active duty for more than 30 consecutive days, RC members have comprehensive health care coverage under TRICARE.

Link Posted: 2/18/2006 3:17:39 PM EDT
[Last Edit: 2/18/2006 3:39:54 PM EDT by TRW]
Tricare will cover any legitimate emergency care at 100% as long as the emergency room visit is reported to your PCM within 48-72 hours or some shit.

ETA: forgot about the co-pay
Link Posted: 2/18/2006 3:48:09 PM EDT

Originally Posted By Hydguy:BTW, the military hospital never shuts down. The ER on base is ALWAYS open.


Not all bases have ER's any more as they are closing more and more military hospitals & turning them into clinics as cost cutting measures thanks to hilliary care. Heck, the base here is covered by AMR and rolls from off bas when anybody on base needs a ambulance.

The one my wife and kids goes to is no longer a hospital, but a "clinic" as they have done away with the OR & ER. I go to the local VA & while they have a "ER" It's more of a clinic and for any real emergency they call 911 & have you transported to the local ER in a ambulance.

We do have a local "Doc in a box" who takes tricare & the ER does as well.
Link Posted: 2/18/2006 3:49:42 PM EDT

Originally Posted By PeteCO:
Good. I was beginning to think you were the biggest fucking idiot I had ever seen on Arfcom.



No, that's some goober named PeteCO
Link Posted: 2/18/2006 3:50:40 PM EDT

Originally Posted By PeteCO:

Go fuck yourself. I didn't ask your opinion, sport. And presumably, when someone posts, it IS "the whole story". He only had to add to his story because it was initially incomplete, yes?




I rest my case.
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