My Family!!

My Family!!

Wednesday, December 1, 2010

Some Peace and Quiet

For the first time in a while, I feel like I don't have much to talk about. Things are at a standstill in just about all aspects of my life for the time being. This is probably a good thing! I am going to bask in this week of very little action. With the holidays approaching, I know it will start getting really busy!

Foster and I did run into some problems with Tricare (the military health insurance). We were under the impression that I was signed up since last December. We had gone in the week after our honeymoon and had me put in the system. I had a dentist apointment this past week, and when I gave them United Concordia as my secondary insurance, they called and the insurance program said I was not listed under his dental OR medical insurance. When Foster called Tricare today, they said I was not qualified for the insurance. I had been denied but no one had bothered to inform us about it for 12 MONTHS!!!

The ONLY real "qualification" I need to fall under his insurance is to be his wife, his dependant. We had me put under him in the system, so there should be no issue. He has to wait till tomorrow to go into the DEERS office and find out what happened. I wonder if there were some wires crossed since I am in the system for being a soldier, and since I am considered a reservist, I don't qualify on my own unless I pay for it, which I don't since I have insurance through my job. Thank GOD I have insurance through my job and decided to keep it after we married, because my insurance covers my high risk doctor and we weren't sure if Tricare would. Because of this, my dental visit was covered with no issues, and it also gave us the heads up that I wasn't under Foster.

I have another family shoot coming up this Saturday. Another one of Foster's families is wanting a Christmas shoot. I am excited, because if the kids can handle the cold, there is supposed to be snow on Saturday, and I think it would make for some beautiful pictures!

Finals start next week, and then after that Foster and I are off to our nation's capitol. Every Christmas for the past 3 years we have gone. It is beautiful this time of year, and we look forward to the National Christmas Tree and getting our picture taken with Santa. At the end of our trip, we are heading up towards Baltimore where we are meeting up with one of my closest BLM friends. I met her on my support group, and we talk to each other on the phone at least once a week, sometimes more. We have gone through this journey together, and we seem to always be in the same spot emotionally. We really bonded, and I consider her my "soul mate" in this journey. I am ecstatic to FINALLY meet her in person! I am sure I will have TONS of pictures, and look forward to sharing our trip with all of you.

So right now, I am enjoying the little break of peace and quiet before life starts picking up again.


kristen west said...

if you have tricare prime and you get a referal from your primary care doctor, then you high risk (speality) would be 100% covered. we have prime and my surgery and treatments have all been covered 100% (i know they have been well over $40,000)...sometimes you have to argue with deers and tricare to get anything accomplished :)

~Amy said...

Wow, a screw up in Tricare... I'm shocked. ;) Yeah..
To the previous comment, we were denied referrals by our PCM on base to be seen by a children's specialist by Tricare. I was struck given the dr ON BASE was telling Tricare he wanted us seen off base b/c he wasn't comfortable treating our son and yet they denied it. Makes a momma bear angry but they don't care. Period.
GL! I hope you get it worked out without too much head ache...

Amber said...

Hi Soulmate!! I was just thinking about you and then saw you wrote a journal--how soul mate-y. THEN saw I'm in it-awww!!

I'm so excited to meet you as well! Did you definitely decide on Bmore that night? I will try to touch base with you soon, I work 12hrs thursday and Friday. xoxox

Olivia's Mom said...

I see you've already received some comments regarding Tricare, but here's one more. :)

Just by my own experiences and knowledge, neither Tricare *Prime* nor UC Dental are automatic when you become a dependent on the DEERS system. For UC Dental, you have to fax in the application form and the initial fee, then Dave will see a monthly charge on his LES for your Dental insurance after that. With Tricare, you *should* have been automatically put on Tricare Standard (80/20 with premiums, etc.), but in order to get on Prime (100% coverage), you again have to apply for it. When James first joined many years ago, I ran into that problem and ended up paying $50 for a basic check up since I was unknowingly on Standard and hadn't hit my premium yet. I had been told I automatically received insurance, but no one told me that in order to get the 100% coverage option (Prime), I had to fax forms in and actually apply for it. Does that all make sense?

Also, a high risk doc IS covered under Tricare Prime. I'm seeing a civi OB right now through a referral from my PCM and she will be sending me to an MFM in Atlanta...all of which is free of charge because I'm on Prime. In our almost 9 years in the Army, I've never paid a dime for any specialists or any care, period -- on post or off. The only thing you will still pay for on Prime are the copays for prescriptions if you don't get them on post (assuming that will apply to you since you're in OH).

Good luck with everything!

Rhiannon said...

Have a wonderful trip to DC, it's such a fun town! ( I lived up there for 4 years when I was stationed at Walter Reed :)

I can't wait to see pics from your BLM meet up...BLMs are the best and in even better in real life. Have fun!! ((hugs))

Holly said...

That's crappy you weren't on the plan and even crappier they didn't tell you!!!

Hope you have a good shoot!

That's so awesome you get to meet up with your friend and finally meet her in person. :) Hope you have a great time!


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