Molly Mathews

My name is Molly. I have been married for 5 years and have two children. A 10 year old step-son, a 2 year old daughter and I am currently 26 weeks pregnant with a boy! I live in the town I grew up in and have a large family that I see often. We all live close to each other right now and I hope it stays that way as we draw a lot of support from one another. I have been a nurse for 6 years, mostly in the emergency department, and I love my job. Since young childhood I dreamed of being a nurse and a mom and here I am both! I couldn't have imagined how difficult the journey would be but neither could I have fathomed the Joy that would come from both. Becoming a mom has made me into a better person in many ways and a bit of a crazy worry wart in other ways! Having support from other moms who have been there before or are there with you makes all the difference in the world!

kelly-mulder

Hmmm… Really, Tricare?

Me 33 weeks pregnant with Nora. Will I have to prove I'm pregnant at 33 weeks this pregnancy?

I have been very impressed with Tricare until we moved to VA Beach for the summer. I love the excellent coverage (with Nora’s pregnancy I didn’t have to pay for anything). I’ve loved all of the doctors I’ve met with at Camp Lejeune. I’ve even had positive experiences with the referrals I’ve received to go out in town.

So what am I not happy with?

I needed to switch my care from Camp Lejeune to Virginia Beach so I could continue getting the prenatal care I need. Sure I probably could have just not seen a doctor for the three months we are in Virginia Beach but I’m not a gambler and that wasn’t a risk I wanted to take.

So I called Tricare and had my provider switched so I could receive prenatal care. All of the base medical facilities were full so I had to make an appointment with a new medical facility out in town. I asked the woman on the phone if this place provided prenatal care and she said, “No, but you need to be seen there to confirm your pregnancy then they will give you a referral to receive prenatal care.”

Hmmm… so I’m 20 weeks pregnant, I’ve already had the confirmed pee in a cup pregnancy test, two ultrasounds (one of which revealed I have a very healthy baby boy), and multiple visits with a Navy doctor concerning JUST my pregnancy. Yet Tricare wants to CONFIRM my pregnancy before I get a referral to receive prenatal care?

That’s just crazy!

The doctor I visited today agreed with me. She said it didn’t make her feel good either, that she just felt like a paper pusher for Tricare but she was willing to jump through the hoops they needed.

I just don’t understand why Tricare is wasting money for me to confirm my pregnancy when reliable health care providers have already documented my pregnancy. It also makes me wonder if I’m going to have to confirm my pregnancy yet again when I move to Okinawa (at 33 weeks).

Have you dealt with anything like this?

 

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3 Comments on “Hmmm… Really, Tricare?”

  • Kristy Brandt May 27th, 2011 12:38 pm

    Throughout my entire pregnancy with Carrington I had issues with Tricare. I was considered high risk and yet they denied my request to be seen by a high risk OB until the base OB/GYN made their recommendation. Problem was in SC the base OB/GYN clinic won’t see you until you are over 10 weeks pregnant. My condition needed to be monitored from the moment I found out I was pregnat. My husband and I were so unsatisified with the prenatal care I received that we have decided if/when we have another baby we will pay out of pocket to go out of network to receive my care. I really hope that things get better for you.

  • Stephanie Geraghty May 28th, 2011 1:56 pm

    I have not dealt with this in terms of pregnancy, but definitely have in doing all the medical appointments and phsyical therapy for Cole over the past 6 months. I have learned that Tricare wastes MUCH more time and money than necessary. The process could definitely be more streamlined to ensure the sanity of its customers. But there’s no way around it. They don’t bend on anything. I’ve tried. I hope you don’t have to go through that again in Okinawa. At that point, it would be beyond ridiculous. 33 weeks! SHEESH. Miss ya Kell.

  • Kelly Mulder Kelly Mulder May 29th, 2011 6:50 am

    Kristy,

    I remember when you were having trouble with Tricare. I couldn’t believe it then!! and I honestly was thinking they had fixed that glitch in the system by now. It REALLY doesn’t make sense to me why any pregnant woman would have to prove she was pregnant again -especially someone who is high risk! You should have been seeing a doctor right away. You should not have needed to wait for any amount of time. I hate to say it, but I think you would have run into problems with tricare no matter how far along you were. Tricare is supposed to be military friendly and understanding about PCS moves but with all of the stories I’m hearing they really don’t seem to be. I sent Tricare a copy of my blog hoping for a response but I have yet to get one :( .

    Stephanie,

    I can’t believe that in this day in age Tricare would be so willing to waste money. That really is what all of these unnecessary appointment are -a waste of money. All of the other companies are cutting back, streamlining, etc. and Tricare still is enforcing policies that waste their money. I’d love to have someone review all of their policies and throw out the ones that don’t make sense. It would have made much more sense for my doctor and Kristy’s doctor to write a letter stating our condition and approving us for prenatal care -without a wait. I don’t know the specifics of Cole’s situation but I’m sure you have some recommendations for how Tricare could have handled it better. Thanks so much for commenting! I miss you too!
    Kelly

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