Military Health Care at its Finest

 

The healthcare provided to active duty military and retirees is called TriCare.  TriCare is divided into regions dependent on where you live and your coverage is dependent on your status and your choice of coverage.  We live in the TriCare West Region.  This used to be administered by TriWest Healthcare Alliance.  It is now being managed by UHC Health Care.  That covers the background of what is going on.  Now let’s start with I can not stand bureaucracy and stupidity.

 In and endeavor to find out (or at least eliminate possibilities) why my son is angry almost all the time we had a sleep study done.  The conclusion was that he does not have sleep apnea, but he should see a sleep specialist.  The sleep study was done 6 months ago and we have an appointment on Tuesday to see the specialist.  Yes it took us that long to get results and an appointment at Children’s Hospital in St Louis, two hours away.

 

This morning I got a call from the hospital asking if Jeffrey had a referral.  Well, yeeeessss, we had one for the sleep study and this should cover it.  But, dutifully, I called TriCare and asked.  And yes, that referral should cover it.  Our appointment is on Tuesday.  The referral expires on Monday.  Aaaaaaahhhhh!

 

It would seem to me we could just extend the referral for one day.  Easy enough, right?  Uhm, no that isn’t possible.  Well, of course it isn’t.  Why was expecting anything else?  And why isn’t it possible?  Oh, because the original referral was under TriWest and UHC extended all of those referrals one time.  They will not be giving any of them further extensions.  At all.  Period.  No exceptions.  Not at all.

 

So now I had to call my Pediatrician here in Rolla and ask if she could please put in a new referral today marked urgent.  And just HOPE that UHC takes care of this within 24 hours.  I guess I will be calling and harassing them again tomorrow and on Monday.  If I can not get this referral through by Monday I will have to reschedule with the specialist.  And his next available appointment will be in 3-4 months.  *SIGH*

 

Why do insurance companies and our government make it so difficult for something that should be so simple.  The doctor asked for it.  Please do it.  I made my choice about how thorough I would like to be while sitting at my doctor’s office.  Quite frankly I already personally questioned weather this appointment and the ensuing headache was worth my time.  But I found a pediatrician that I respect and trust.  Therefore, when she said, “Yes, it’s worth pursuing so we can at least rule this out,” I believed her.  Why can’t my insurance company make it that simple?  It was obviously approved before.  Why wouldn’t it be approved again?  Why make all of us go through so many hoops?

 

I know I am not the only one who goes through this sort of thing.  And my son’s problems are pretty mild compared to other people I know.  Why do the insurance companies get to shove bureaucracy in the way of competent health care.  I have been frustrated for a long time with medical insurance.  There are no easy solutions, but maybe we need to find some hard ones.