Tri-Care

***Read with caution, no proof-reading has occurred, and I was typing at the speed of light***

The military's health insurance/health care is through a program called tri-care. In Guam, I had had a really bad experience with tri-care and had come to believe that it was worth about what we pay for it: $0. When you're in the military, health care can be virtually free. But, I was rarely able to see a doctor, I was denied multiple referrals to specialists, and I got little to no OB care. I guess on a positive note, when I did get prescriptions they were always filled free of charge.

When we got back to Savannah, I was convinced that I wanted to change our tri-care to a plan that is more flexible but you pay 20% co-pays on services (this is not an option in Guam). After talking to the health insurance counselor here in Savannah at Hunter Army Airfield, she convinced me that Guam was a special situation and that the less expensive tri-care option in Savannah would be a much better experience. See, the pay version allows me to make appointments out in town and see whoever, whenever based upon whether the doctor is in the tri-care network. The free version requires me to go through a primary care provider for EVERYTHING.

Note: the general practitioner that I had seen in Guam said to make sure that I get my "20 week anatomy" ultrasound BEFORE 23 weeks. It is most ideal to have this ultrasound done between 18 and 22 weeks pregnant.

Week 1 in Savannah (I am 19 weeks pregnant): We filled out the paperwork to move me from the Guam system to the system here in Savannah, and we stayed with the less expensive option of tri-care based on the counselor's recommendations. We had to wait 3-5 business days for the paperwork transfer to happen...

The paperwork has been done the same week, and I am assigned to a primary care provider at Hunter Army Airfield. She is a civilian nurse practitioner that is about my age. I immediately call to make an appointment with her for a referral out to an OB. After all, I was overdue for the baby's ultrasound that confirms organs, bones, etc are all there and properly formed. (If you wait beyond 23 weeks, the baby starts to begin forming fat and the organs are not as visible via ultrasound. Additionally, there is less room in the uterus for the baby, and she can be harder to view. The first available appointment was the following week...

Week 2 in Savannah (I am 20 weeks pregnant): I finally see the primary care provider. I state that I am 20 weeks pregnant and explain the urgency of me getting ultrasound. The sex of the child was also to be determined at this ultrasound, and I wanted Brian to be there. I am clearly pregnant at this stage. The NP says, "well, we can't just give you a referral for an ultrasound. We have to have a positive pregnancy test on file here at Hunter." ARE YOU SERIOUS!!! I was clearly pregnant to any stranger at this point. I pulled out my files from Guam, and she said that that should suffice. I also explain that the Dr in Guam had said that his needs to happen before 23 weeks due to the extra fat and tighter space. The NP says, "I have never heard of that before." My confidence in this woman is at about a 1 on a scale of 1 to 10 at this point. The NP then agrees to give me a referral to an OB in town in Savannah. She said it would take another 3-5 business days for the referral to be processed, and then I could make an appointment. She also explained that it couldn't happen any faster because my situation was not an emergency.

When I got home from the doctor, my mom asked who I had been referred to. She said, "Oh, I see Dr. XXXX. Katie, she no longer does deliveries." So, I call the Dr's office and yep she no longer does deliveries. I call the tri-care people and explain the situation. They said that the paperwork was already in process, and it would be a couple more days until they could do anything.

Week 3 in Savannah (I am 21 weeks pregnant): The tri-care people call me back in week 3. They said the referral had been "denied." Apparently, the NP wrote that the patient "wanted" an ultrasound but made no mention that I was pregnant OR overdue for the ultrasound. The tri-care people put in another referral, and said that I would have to wait an additional 3-5 business days for it to be processed...

Week 4 in Savannah (I am 22 weeks pregnant): The tri-care people must have noted the desperation in my voice by this time, because the referral happened in record time.

About this time, Brian leaves for S. Korea.

I had asked to see Dr. Crute, but for some reason when the referral came through I was assigned to a Dr. Decker. I called for the appointment and the first thing they had was in mid-June. Of course, I explained the entire situation and that I was overdue for my 20 week ultrasound. They said, "Ma'am, first appointments have to be with our nurse practitioner."

Week 5 in Savannah (I am 23 weeks pregnant): I finally arrive at my appointment. Although the tri-care referral had been to Dr. Decker, they had reassigned me to a Dr. Linfoot. What the heck is going on here!!!

It turned out that the OB's NP was great. She scheduled an ultrasound for me the next day, AND she put me back on Dr. Crute's schedule (the original person I had asked for).

Although I still haven't met the OB yet (I will in about 3 more weeks), I did get the ultrasound at 23 weeks, 1 day pregnant.

Whew!!!