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Sunday, September 20, 2009

Which TirCare to choose?

Choosing your medical plan is a huge decision that affects not only yourself, but your family as well. I hope this post helps you make an educated decision; Prime or Standard/Extra, it's your choice.

Things have changed for the better since I was a child on Prime. But my experiences as a child and now as a wife still push me to stay Standard and my husband and I have chosen to put our son on Standard as well.

Here are true experiences that prompt me to stay Standard:

1. At Fort Stewart a young woman was suffering chronic fatigue, acute displaced pain, and other symptoms. After two years at Winn they finally out sourced her to Liberty Regional Medical Center for Pain Management. As apart of the Doctor's preliminary testing, she tested positive for Hypothyroidism. A Condition that is easily regulated with medication and but can be extremely dangerous left untreated. Prime does not cover this simple blood test with their Primary Care Managers.

2. I have hypothyroidism (No I am not the lady mentioned above). And with it you take synthetic thyroid to regulate and make up for what your body doesn't produce. If you have low thyroid levels while pregnant it can cause low IQ levels in your child. Prime would not cover regular blood draws during my maternity care to make sure my hormones are throwing my thyroid out of whack. Thank God I am on Standard because I have had to adjust my medicine during my pregnancy.

3. The average wait for Winn ER is over 8 hours. Ask any wife on post. The average wait for the ER at Liberty Regional, directly outside of Fort Stewart, is less than 2 hours; more often less than an hour. (They have a fabulous Fast Tact ER attached to the ER for the less severe cases)

4. With Prime it can be difficult to get referrals for specialists. I have to see an endocrinologist about my thyroid because I have a severe case. Standard it is too easy to pick up a phone and make an appointment. OBGYN's are considered specialists and you need a referral as well.

5. With Prime, costs are covered 100%. With Standard you have a $150 for individual $300 for family deductible. After you meet your deductible you enter into cost share. Now, maternity is covered completely under Standard as well, with a $15.65 per day/$25 whichever is more co-pay for hospital stays. With all the specialists I see, and I have to get paps every 3 months (it's so lovely, but cervical cancer runs in my family and I am very high risk), I still don't pay that much at all.

6. My father's kidney ruptured on my 17th birthday. He never knew he had a enlarged kidney or that was causing his horrible back pain. He had complete coverage from the Army for his entire life, from birth until current, and no one caught this problem. Rather traumatizing to walk into the hospital room after your father has had to have emergency surgery removing said kidney.

I am very lucky when it comes to health care because my Mom works at a hospital directly outside a large Army post, so she is always up to date on TriCare issues. I am also spoiled because the Doctors knew who my Mother was and I admit I got special treatment. Now I am no longer in that area I expect the same level of care and have yet to find that with Prime, though I did give it a try at Jackson. I quickly transferred back to Standard and found my own OB for my pregnancy.

We all have our own opinions but you have to make what is best for you and your family. I choose to stay Standard and give my child the best possible treatment.

And NEVER let a resident treat you without seeing an Attending. You should always see a Major or higher in Military Treatment Facilities.

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