Insurance: Tricare

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We have a lot of members that have Tricare. Many of us have hit road blocks in getting good care. Here is what I have learned:

If you have Tricare Prime you will need a referral to see a Gynecologist for pelvic pain. If you are at a base that has a Gynecologist it will be harder to get expert care. Most likely you will have to make a case why the base doctor cannot help you. Complicated cases with bladder, bowel, and/or diaphragmatic involvement have a better chance for off base referral. If you have had multiple treatment failures you can advocate for yourself to go off base also. A patient advocate may be needed if your PCP continues to refer to base doctor. If you can get your off base referral change the doctor to the doctor of your choice. You have the right to see any doctor that accepts Tricare prime. You might have to sign a waiver stating you will cover your own travel expenses. If you take a chance and use the Gyn referral they give you and that Gyn says they can’t help you there is a remote chance they will also cover your travel to see a specialist. I personally wouldn’t chance it as many Gyns will say they can treat you when really they may have little clue. If you have Tricare Standard you can self refer. With Standard you will have a share of costs but there is a cap on it. Double check for exact amounts with tricare. We have several doctors on the list that accept tricare. I feel I am very fortunate to have tricare even if it takes a big fight sometimes to get what you need.