So I'm trying to decide...

...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?

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 ) 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

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

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.

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.

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!

Good Luck!

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!

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

WAY TO GO GIRLY!!!!!