When we moved to Jacksonville, Florida, I was deep into the first trimester of an extremely high-risk pregnancy. Since our family has also been stationed in Pensacola, Florida and Albany, Georgia with Tricare Standard (now known as Tricare Select), the last thing I expected was to have a difficult time accessing any type of medical care – especially in a city as big as Jacksonville. Unfortunately, while trying to find a doctor, I spent days calling dozens of offices, and each office told me one of three things:
- I was too high-risk for their practice, considering my medical history. (Even a high-risk practice told me this!)
- They did not accept Tricare at all.
- They had already met their quota for my type of insurance with my projected due date.
Qualifying Life Events
Fortunately for our situation and the health of our baby, moving is considered a ”Qualifying Life Event,” which allows you to change the type of Tricare insurance (Prime or Select) that you have. However, pregnancy is not considered a Qualifying Life Event – though an actual birth or adoption is a Qualifying Life Event. Confusing right?
By switching to Tricare Prime, I was finally able to access care in my second trimester of pregnancy. Otherwise, I would have been left without a provider, and considering that my pregnancy ended in placenta previa and required an emergency hysterectomy, without the prenatal care I received through Tricare Prime, both my baby and I would have died trying to birth.
Allison Burgoyne planned to go to her nearby hometown and give birth at a birthing center. When she failed a glucose test, her plan fell through, and she found herself in the second trimester without a doctor. Due to being at a small duty station, she was unsuccessful in trying to find one on her own that would take her right away, especially with the possibility her pregnancy was just upgraded to a high-risk one. The few doctors that did have room in their practice couldn’t get her an appointment until mid-November, approximately the week before her due date.
After being urged to call Tricare to explain her situation and request to be transferred to Tricare Prime so that she could at least be seen at her local military clinic while she waited for a referral. Tricare refused to allow her to switch, stating she was not within the parameters for a Qualifying Life Event, which left her hoping that Naval Hospital Jacksonville would have space for Tricare Select patients in their OB department and could take her, which was nearly an hour away from their home.
Enrollment Season is Not Working for Military Families
When Tricare rolled out with their enrollment season plans, the response in our community was, “Oh, it’s like normal insurance,” and we accepted it. What we failed to account for is that we are not like normal families. Normal families do not move every 2-4 years and have to make an insurance decision within 90 days of that move and hope that they made the right one because they only get one shot at selecting Tricare Prime or Select. Due to the servicemember’s sacrifice, many dependents are also exposed to things they otherwise would not be that may affect their health, such as contaminated soil, contaminated water, and mold – which all lead to health conditions that the base clinic may not be equipped to treat, such as severe asthma and cancers.
Military Families Deserve Better
When the government is denying claims related to Camp Lejeune and families practically have to fight their own war to have any type of mold remediated in housing, the one the thing we shouldn’t have to worry about is if we’ll be able to get adequate healthcare treatment – especially if the military was the cause of our health issues or we suddenly become ill and the base doctors are unable to diagnose.
Without the ability to switch our type of insurance if we are not receiving quality healthcare, people will die because they will be either unable to see a regular doctor, the military doctors will have no idea how to diagnose them, or they won’t be able to access a doctor at all because you can’t go to urgent care to treat complex health conditions. Tell me, how does this look for mission readiness? How many of our spouses will ultimately leave the military so we can access better healthcare?
