Tag Archives: TRICARE

TRICARE’s Breastfeeding Policy: A New Mom’s Experience

Recently, TRICARE implemented a new breastfeeding support policy including coverage for breast pumps. Our Association is generally pleased with this new policy because it gives families flexibility in terms of when, where, and how to purchase breast pumps and supplies.

But we wondered how this policy is panning out in military communities as families try to use it. So we asked Jaclyn, a Fort Benning Army Spouse, while she was expecting her first baby. Jaclyn had just purchased a breast pump.


I heard about TRICARE’s new breast pump policy from an online moms group.  I called TRICARE even before the policy went into effect and they were able to answer some of my questions.  They were at least aware that the policy would go into effect on July 1.

Back in August, I started to think about buying a pump again, so I needed to learn about the process for getting a pump covered by the new policy. At that point I was only seeing my midwife once a month for appointments.  I wasn’t sure if I would need to get a prescription before buying the pump. I checked my online Army Moms group and saw a post about how to buy a pump at Target so I decided to give that a try.

I called the 800 number for the Target breast pump program. They collected some basic information about me and my TRICARE coverage and then they took it from there. They sent me an email with three choices of pumps that would be fully covered by TRICARE. They also provided some options where I would have to pay part of the cost out of pocket. I chose the Medela In Style Advance (retail price approximately $200 at Target.)

It turns out that I didn’t even need a hardcopy prescription – Target followed up with my midwife directly to get the prescription. Target emailed me with a list of locations where I could pick up the Medela pump. I chose one and went to the store. I stopped by the Target customer service desk and the pump was there waiting for me.  I didn’t have to pay anything given the pump I selected!

My experience was pretty easy, but my friends on TRICARE Prime seem to be having a more difficult time. Some of them are having trouble getting a prescription from their OBs. It seems like Pediatricians are more aware of the policy and will provide a prescription without a problem. 

How does Jaclyn’s experience compare to yours? What worked well and what did not? Share your story with us in the comments section below.

And don’t forget about lactation counseling! We talked with Jaclyn while she was still expecting, so her story doesn’t touch on breastfeeding counseling. Have you tried to use TRICARE’s new coverage for lactation counseling?

Your stories will help us understand if TRICARE’S new breastfeeding supplies and support policy is working as intended.  Thank you for helping us advocate for military families!

karenPosted by Karen Ruedisueli, Government Relations Deputy Director

Do White Coats Make You Nervous?

doctors_black and white photo-550Do white coats make you nervous?! Because they sure make me anxious! I’ll be honest with you: just the prospect of going to the doctor’s office makes me sweat. And don’t even get me started on the dentist. No, I am not scared of shots. But I am scared that whatever help I need, I won’t get. And that is a very real fear!

As military dependents, we don’t have the luxury of picking medical providers. Under the best conditions, we can ask other military dependents who they recommend, and under the worst, we are flying blind. So, the question becomes: How do you get the care you deserve and need with a practitioner you don’t know? The answer is: advocate for yourself and partner with your healthcare provider!

Here are some things you can do to help get your medical needs met!

  • List your concerns and the needs you want met. Make sure they are prioritized. This sets the stage for your exam, for both you and the provider. Don’t make them hunt down the reason for your visit; if you are there for a run of the mill check-up mention it, if you are there for specific reasons tell them.
  • Negotiate with the provider what issues can be addressed today, and if you will need another visit to address the rest. This way the two of you will have realistic expectations about what can be completed today. You don’t want to leave your appointment and feel like nothing was accomplished. Nor do you want to rush through! Be aware that different appointments are allocated different amounts of time. A first time visit to a new primary care provider may be a 45 min slot at one practice. While an appointment for a specific problem may be a 15 min slot.
  • Prompt your healthcare provider! Ask them what they think about your symptoms, what else it could be, and what tests they will run. This will pull your healthcare provider out of his or her tunnel vision. You want to inspire them to think outside the box. Just in case!
  • If they prescribe medication: What is the medicine for? What are the side effects? When should you take it? Will it interact with any of the medications you are presently on? And will it interfere with your daily life at all? The last thing you want is to go home with a medication that you don’t fully understand!
    If you aren’t happy, say so. Fill out a patient satisfaction survey. Let someone know. Nothing is going to change unless you say something!

Now, if you are reading this and you are saying to yourself, “I can’t be that assertive with my provider,” then bring a friend. Bring someone, anyone, who will advocate for you or just be there for you emotionally so that you can feel supported.

Recently, I heard a talk by August Fortin, an MD who specializes in patient centered care, and he acknowledged that “being a patient is amazingly disempowering.” We all know that feeling, especially when seeing a healthcare provider you don’t know about an issue you might be really nervous or uncomfortable about. But you can take that power back. You should get the care you deserve!

What experiences have you had with a new provider? What tips and tricks do you have to make it an easy transition?

katie-mccuskerPosted by Katie McCusker, NMFA Volunteer, US Coast Guard spouse, and ACNP student

Sick and Tired: Military Kids Need Better Access to Same-Day Care at MTF

Child-at-MTFRecently, when a military spouse at our Association told me she had to take her baby to the emergency room when there were no appointments at their Military Treatment Facility (MTF), I thought my head was going to explode.

I flashed back to one of many similar situations I faced when we were on TRICARE Prime, and my daughter, Kate, was in her ‘ear infection phase.’ On one memorable occasion, Kate started a fever on a Friday night (of course, after the MTF was closed for the weekend). By Saturday, the telltale ear tugging and crankiness were in full swing. I kept my fingers crossed that we could keep things under control with Motrin and Tylenol until the clinic reopened on Monday. Unfortunately, by Sunday she had a 104 degree fever, obvious signs of a ruptured ear drum (I’ll spare you the details), and was crying inconsolably.

I knew we couldn’t wait until Monday for an MTF appointment, so with a newborn crying to be fed and a 20 month old wailing in pain, I braced myself for an uphill battle to find medical care that TRICARE would cover.

I consulted the TRICARE website where it seemed like our only option was the emergency room. This concerned me; did a ruptured ear drum constitute a threat to life, limb, or eyesight? I was terrified of having to foot the bill for an ER visit.

Not willing to risk it, I called TRICARE. They told me to take Kate to a network urgent care and call our primary care manager (PCM) on Monday to request a referral.

I think you know where this story is going…

On Monday, I called our PCM, who refused to give me a referral because the appointment had already taken place. When I called TRICARE back, their hands were tied. Without a referral, they could not pay the urgent care provider. We were at an impasse, and eventually paid out of pocket for that visit.

The reason this particular incident is burned into my memory is because it occurred while I was recovering from a c-section, and we were about a week away from PCSing. My husband’s new unit had orders to Iraq, but the departure date kept moving, causing second and third order effects… most notably on our temporary housing plans. Oh, and we had just learned (from CNN – surprise!) that Army deployments were being extended to 15 months.

Military families lead complicated lives full of uncertainty. Getting a sick child appropriate medical attention should NOT be complicated.

The National Military Family Association has advocated for years to fix this problem.

And, in fairness, things have improved.


At certain locations.

For instance, our old MTF in Virginia, the Woodbridge Clinic, is gone now. It’s replaced with the Dumfries Clinic, which has improved appointment access by adding Saturday hours.

Yet, we still hear of too many instances where families can’t get same-day appointments at the MTF, are refused referrals to urgent care, and are left with no option but the emergency room for their sick kids.

This is just wrong.

As the health care subject matter expert for our Association, this issue is not only my job, it’s personal. Now is the time to fix this problem once and for all. Military families deserve access to the best care, including same-day appointments for urgent issues.

Please help us by signing our petition and sharing your experience with access to same day appointments in the comments below.

karen-rPosted by Karen Ruedisueli, Government Relations Deputy Director

Since When Does MTF Mean ‘Might Take Forever?’


Did you know garlic is a powerful antibiotic?

I didn’t either, until I had lived in Germany on an Army post for a couple months.

One day, my daughter woke up with a fever. It was just high enough to have me worried, so I waited for the appointment line to open for the day, and called as soon as the clock rolled over to 7:30am.

We know how this goes, so of course, I had the number programmed in my phone. All the better to dial quickly. By 7:31am I had navigated (like a pro) through the menu options and found myself on hold, waiting to talk to a representative.

“There are seven calls ahead of you.”


My heart sank. Seven isn’t great. Seven means it’s likely that the appointments for the day will be filled before they get to me. But, being the optimist I am, I hung on the line.

After all, my baby daughter had a fever. She’s never sick, and even after being trained as a nurse, fevers in infants worry me. The hold music starts playing, and I pulled out the thermometer again. I held my breath and hoped.

Nope, the fever was still there. She’s was flushed, and clammy, and crying, again, because I just had to take her temperature one more time.

“There are four calls ahead of you.”

It’s now 7:45am and I am losing hope. I’m bouncing the baby and waiting.

Finally, a representative comes on the line, gets my husband’s social security number, and asks me to explain the problem. I do, and the baby screams, filling in the gaps of my story with her own frantic song.

“The earliest we can get you in is Friday. There is an appointment at two.”

Today is Monday, and we need seen now. Friday won’t work. On Friday, she’ll be fine. Or, as my overly worried Momma brain starts thinking, she’ll be dead.

The only other option is to take her to the emergency room. Germany doesn’t have an urgent care system, and other than the small clinic on post, there isn’t an American facility to go to. However, the German children’s hospital is amazing, if your child needs a hospital; if you have an infant with a fever, it’s really not that great. What I needed was antibiotics for an ear infection, and the reassurance that I was doing the best I could by hydrating and comforting my child at home. What I got was excessive testing in the German hospital, hours of waiting, the stress of not being unable to understand the system, and the flu (probably from the arm rests in the waiting room).

Unfortunately, this situation happened to me again, and again, for the three years we were stationed in Germany.

During our tour there, I was only seen ONE time for an urgent matter in the pediatrician’s office, and that was because I sat in the office and refused to leave until someone could help me.

I learned quickly the best I could do was attempt to help myself. I learned that garlic is a powerful antibiotic… in large doses. And believe me: you really haven’t lived until you’ve tried to get your five year old to swallow four cloves of fresh garlic to treat a suspected ear infection.

I learned Germany has an extensive alternative medicine culture, and in a pinch, I could go to a pharmacy off post and communicate my problems (in terrible German) to their pharmacists. I learned essential oils can help, and sometimes, you just have to suck it up and spend two nights in the German hospital for an issue American doctors would treat as urgent care, and send you home.

This has to change. Our military children deserve better. As wonderful as alternative medicine and emergency rooms are, we shouldn’t be forced to use them because there aren’t enough appointments, or doctors, to go around.

In the meantime, I’m stocking up on garlic.

Have you had problems making an MTF appointment for a sick family member? Please tell us about it and include the approximate time frame (we are most interested in recent situations to show this is a current problem). We will compile your stories and share with Congress and senior DoD leadership.

heatherPosted by Heather Aliano, Social Media Manager

Storming the Hill Since 1969! #WayBackWednesday

It’s the 1990s, and our Association is making waves on Capitol Hill. During this decade, we released an innovative health care plan for military families, which included recommendations that were later incorporated into TRICARE.

Twenty years later, we are still on the forefront of TRICARE issues, including those controversial topics that your military family needs answers to. Not finding the answers you need? Leave us a comment and let us know how we can help!


Navigating the TRICARE maze: Prime vs. Standard



In-network vs. out-of-network.

I’ll have a whole new vocabulary once I master the TRICARE maze!

For the past 9 years, I’ve used TRICARE Prime. I’ve seen doctors at Military Treatment Facilities (MTFs) and in town. I thought I scored big time when I was assigned a Primary Care Manager (PCM) out in town because the base was too full to take new patients. When we were stationed outside of Washington D.C., I navigated between multiple MTFs to get the care I needed.

It’s not a perfect system and there are some glitches. For example, accessing records between an Army hospital and a Navy hospital…let’s just say it doesn’t work as well as it should. The different systems don’t always “talk” to each other, which means you may need to hand-carry records, especially ultrasounds, MRIs, or other digital images between MTFs. And if you do see a civilian provider off the installation you’ll also need to carry records between providers.

With Prime, one thing I never had to worry about was cost. As long as I had referrals and pre-authorizations – I had minimal co-pays, if any at all. In fact, I had our first son while covered under Prime and don’t recall paying anything for my prenatal care, labor, delivery, or post-partum care. I attended child birth classes, met with a lactation consultant, took an infant CPR class, and even left the hospital with a bag full of goodies for our newborn.

Four years later, we are expecting our second and I decided to switch to TRICARE Standard. Why? Because when I got pregnant, I was recalled by the MTF, even though I live more than 30 miles from an MTF and was already seeing a civilian provider in town. And, unfortunately, the MTF I was recalled to doesn’t have the providers I need. I didn’t want to navigate appointments in opposite directions driving 30 miles one way to the MTF and 30 miles in the opposite direction to specialists.

I thought I understood the deductible, co-pays, and cost-shares under TRICARE Standard. Yet, maternity care has its own set of cost-shares, too. I’ve learned to keep copies of my Explanation of Benefits (EOBs) and any bills I receive directly from a provider. I call my regional contractor frequently to review claims and ask questions. I discovered my OB’s billing office isn’t an expert on TRICARE billing, and as a result, I was being overcharged. I had the same problem with overcharges for lab work, too.

And I discovered the hospital education benefits I enjoyed at the MTF with my first pregnancy aren’t covered. There is a fee to take a child birth refresher class or meet with a lactation consultant.

Our second baby is due in a few short weeks and overall I’m happy with the quality of care we are receiving under TRICARE Standard. I’ve learned I have a role to play in keeping costs down by asking questions about coverage, reviewing bills, reading the TRICARE website, and talking to my regional contractor to understand our benefit. TRICARE Standard has given me the flexibility to see the providers I prefer, but it comes at a cost.

What are your experiences with TRICARE Prime vs. TRICARE Standard? What would you recommend to other military families?

katie2Posted by Katie Savant, Government Relations Information Manager

Middle of the Night Hero – The Nurse Advice Line

mom-with-sick-babyNew mom. Husband is out of town. 4 month-old with a raging fever and barky cough. It’s 3:00 A.M. Oh, and there’s a blizzard dumping buckets of snow.

I haven’t heard this cough before and it sounds like he’s having trouble breathing. Why does my husband have to be gone when I’m in the middle of a crisis? I don’t want to risk our lives taking our infant-son to the emergency room in this weather. So, what should I do?

Medical Advice Is Only a Phone Call Away
Thankfully, the Nurse Advice Line was up and running that night my son came down with pneumonia. And, the good news is that the Nurse Advice Line is back. Stateside military families, including those in Alaska and Hawaii, can call 1.800.TRICARE (874.2273) 27/4 and reach a licensed nurse. This was a godsend when my son was an infant. The nurse was able to ask me questions about my son’s condition. She also offered some at-home remedies to help sooth his symptoms and scheduled an appointment for me the very next morning.

I was very thankful to have a medical professional to call in the middle of the night. Her tips helped calm my son (and his nervous momma, too) and I was able to safely make it to my son’s pediatrician’s office in the morning when the roads were cleared.

Who Can Use the Nurse Advice Line?
The Nurse Advice Line is available to all TRICARE beneficiaries including Prime, Network Prime, Standard, TRICARE for Life, TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult. And if you use Prime and are enrolled at a Military Treatment Facility – the nurse can help you schedule an appointment. Score!

But do you still need a referral from your Primary Care Manager?  Find out here.

Do you think your military family will use the Nurse Advice Line?

KatiePosted by Katie Savant, Government Relations Information Manager