A lot of people sigh and tend to go with the flow in regards to Tricare; especially if they are on Prime. My family is on Tricare Prime, where we have no co pays and must be seen at certain doctors and facilities.
I entered our insurance relationship with the understanding that I had no choice what so ever in regards to my healthcare. The doctor we were assigned was the doctor we had to use. Regardless of level of care. I discovered I didn’t want to make waves with the professional in charge of my care. Who was to say they would do something malicious to you (that’s how my mind thinks)? I’d rather make nice nice with the person I’m requesting Prozac from. But what do you do when you don’t agree with their answer or course of care (or lack there of)?
This has been happening to me and now SB. We all know as mommy lions, we will never take no for an answer or let someone walk on us in regards to care for our children. However, as I have stated before it is a entirely different story when the person you need to fight for is you.
I have been dealing with a negligent doctor since May. He seemed to think I was a bored housewife. He was sorely mistaken; I am plenty busy. Once my MRI showed “several” brain lesions his story quickly changed. Then it went to “either you have MS or plain crappy luck”. Well I’m here to tell you I do not have MS. A spinal tap and a horrible week of recovery proved that. However, since I now have just “crappy luck”, I am no longer worth his time. He has taken over 2 months to write his case notes for my PCM to review and take whatever action he feels. My PCM feels it is a different issue entirely, however, how do you explain these brain lesions; other than scary! I feel I need a second opinion. But how do I do that? Should I do that? Yes, I should. I’m worth it! Since I have decided to pursue this course of action for myself, you can bet I will do it for SB. So my first question is where do you start?
Tricare has already gone ahead and provided a short little answer for those searching via their website. It states “If you want a second opinion, go to your PCM and explain your situation and any questions you may have about the first specialist’s suggested care.” This is a great lead on how to pursue a second opinion, but what if you want a second opinion from your PCM? To me it would be completely awkward to go to my PCM telling them I don’t agree and want another opinion. I like to avoid confrontation at all costs, if there is a will, there is a way.
My suggestion is to go to your Tricare office. Every base has one. Ours is located next to the pharmacy. The other choice I have is scheduling a appointment with another doctor. Several times, I have made an appointment with another doctor in the family practice because I know they will be honest with me about the situation. I am a busy mom, I have no time for nonsensical stuff and will tell you so. Much like today when I walked into my PCM’s office and I told him I was not depressed and his answer was “yes, you are”. Sometimes you are so far at the end of your rope that your “give a crap” button is broken. So when he just called me back a minute ago (while written this post) I let him know I didn’t agree with him. And you know what? He wasn’t too butt hurt about it.
You know, of course, that you are your best advocate. You can and should get a second opinion over any decision or diagnosis that you are uncomfortable with. Another option may be for you to go Standard. Then you can pick your doc and self-refer. Let me tell you: there’s power in the self-refer. But regardless, Friend, I hope you find answers soon. Brain lesions are nothing to wait around and wonder about.
I have a friend who also had brain lesions. If you’d like, message me; I’ll message her, and hopefully hook you two up.
Best to you –
Kelly
That would be awesome Kelly if you could hook us up ;). We thought about standard after our son was dx with hypogam! but going standard is too expensive for us. We go to doctors sometimes 3 times a week per kid. Co pays alone would probably bankrupt us not to mention our portion out of pocket for his medical treatments. Trust me, we have tried thinking of everything. But I love hearing any suggestions. You never know what I haven’t tried.
Ok – I know there are two of you who write this blog. Are you the one who I talk to on FB, or are you the other one? 🙂
Lol. That’s such a great question! I’m the one you talk to on fb