OK, so most of you know the Spouse Thingy spent 20 years in the USAF, right? And when he went in it was with the promise that if he gutted it out for 20, he'd get free medical care for life.
Yeah, that didn't happen. Somewhere along the way someone decided that it was all right to renege on contractual promises made to active duty military members...and now we pay for the honor of being on the lowest rung of the military medical ladder.
Possible bleeding ulcer? We can get you in to see your doc in about 6 weeks. You had excruciating abdominal pain that went away after 5 hours? And this happened more than once? Well, don't go to the ER, you know the pain will eventually go away. We'll see you in a month.
That's not an exaggeration, BTW.
Being on that lowest ladder rung is why we now have a civilian doctor; I have medical issues, I need to see an endocrinologist a few times a year. There are medications I need. And face it, we're getting older, chances are high that our annual visits to our totally awesome civilian doctor will increase.
Now, the Spouse Thingy has been on a medication for a number of years. And over the years it has ceased to work the way it's supposed to, so today Spiffy Civilian Doc changed it to something else, something that will work better for him. He knows it will work better because he was on it before being on the other medication...which TriCare (military medical) decided was the equivalent to the med today's doc took him off of. It obviously was not.
TriCare, in its infinite wisdom, refused to pay for the new-but-he-used-to-take-it medication because the other one is, as far as they're concerned, just as good.
No. No it is not.
It did not work.
It may work in other people, but it failed as far as the Spouse Thingy is concerned. It doesn't matter that his doctor wants him to make the switch because he needs something different...Tricare has decided they know better than the doctor and patient.
Now, we have other insurance. We're fortunate in this. If we had to pay it out of pocket it would be $110 a month for the one medication; we only had to manage the co-pay.
WTH are military members and retirees who have no other insurance supposed to do when some clerk in an office somewhere decides they know more than the patient's doctor? Active duty military don't take home the world's most generous paychecks. Retiree pay is half that of active duty.
This is what you get when you give two decades of your life to service to your country, boys and girls... If you hear the theme to Deliverance while trying to fill a prescription, now you know why...
14 comments:
That is why My Son and his family see civilian doctors. He active duty and has been in for 17 years.
I understand what you mean, unfortunately it is the same for private insurance. My old medicine is no longer working, so the doctor changed it to a new one. The medicine is new on the market. So some idiot decided it was too expensive. (Hello it is cheaper than the old medicine)I had to write a letter and beg them to cover it and the doctor had to write a letter and say I need it to live. They finally said they will cover it for a year and will reevaluate at that time. On the other thing, I think it is horrible how they treat our military and our ex military.
That's just horrible, Thumper. Breaking promises to our military personnel is just unconscionable. I hear people saying that if we had single payer health care for everyone, there would be a bureaucrat between us and our doctor. Hello? They are already there.
Yes, health insurance all over is getting so complicated and frustrating to use. Our state insurance gets more expensive every year and they put more limits on coverage every year. I love it when we get those nice little letters that tell us what medication we are allowed to get. Why oh why do we even have doctors LOL
The VA has been very good to my father so far - but they do not have all of the drugs that he needs to take now with all of his new heart problems. Fortunately, they have a doctor that will try and find something equal or even better.
But let me tell you, when I was the "dependant" of an active duty husband serving in the Navy, I would not have sent a dead dog to the hospital on one base (which will remain nameless). I was wheeled into the base ER because for some reason I lost ALL function on the right side of my body and could not stand. After waiting 3 hours there, the doctor strolled in, never even touched me, and stated "come back when you have a real emergency" and then left. I really feel bad for our men and women in the military when it comes to their healthcare.
The military broke contracts with my brother from the time they got his signature. (I don't have much faith in the military...although I do acknowledge the men and women who protect and defend and fight for our country.)
At any rate, yep - a lot of insurance companies, civilian or military, need a swift kick in the nether regions. Just keep making noise until you're heard. It's the only way the change will be made.
I'm not allowed to talk about health insurance it becomes a little too 'flowery' with interesting four-lettered adjectives.
At the moment we're still getting bills from last August 2008. The last time we called the person mentioned: 'Well, she isn't even listed on your insurance anymore', as if that was the reason for all of this. I wish I could have heard what Matt said to her after that as he has a gift for telling people off in the most polite way...
Yes, the system changed, for the worse. My father is retired AF, I would have been but walked away after almost 14 years active duty, unfortunately I saw the way things were going and I figured I could make the difference up on the outside. I hear your pain, a lot of both vets and retirees suffered through low wages, not very nice duty conditions, and sometimes living conditions, all of us (and our families) suffered something for the honor of doing what we did. As a vet I want to say "Thanks" to Spouse thingy for having gone 20. Good luck getting through it.
Dismounts soapbox shakes head and walks away...
That's just appalling.
That does suck.
The only advice I can give, if you ever do end up facing an impossibly high cost for a necessary medication - Look up the manufacturer. They have crazy amounts of 'assistance' programs set up to help people that cannot afford their medication. I think if you told them what you wrote here (military officer of 20 years, etc) they would probably fall all over themselves for some good "We help veterans!" PR.
That seriously sucks. And is very wrong. The gov made a promise - they need to keep it.
I'm so sorry to hear this. Private insurers really, really suck and take our $$$$ to make their top executives billionaires, but that's another story.
Good luck!
Sadly, the coverage gets even worse when you hit 65. Without the extra insurance (in addition to Medicare and Tricare), they basically do only enough to be able to transport you somewhere else, then toss you out.
Hope things go better!
In Canada( and most modern industrialised countries) There is universal health care. I see the vehemence and mistruths( kind word for lies) that are espoused in opposition to it in the U.S.
I have also noticed that the majority of those against it, are the ones who can afford private medicine.
Military personnel should retain coverage forever, but as has been shown (exposed?) the medical care they are given after the fact when wounded isn't what it should be, even when still enlisted.
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