IC and the Military Healthcare System

[icnmgrjill]

IC And The Military Healthcare System
One Patient’s Experience

By April Chen - Beavercreek, Ohio

I am a 29 year old former teacher with IC and am the proud wife of three years to an Air Force Captain. He is currently stationed at Wright-Patterson Air Force Base in Dayton, Ohio. My experience with the military health system has been both positive and negative. I would take a moment to share some strategies that could help other IC patients working with military health care.

Health Insurance:

The military health insurance program is called TRICARE. Throughout the nation, there are different TRICARE regions. We, for example, are in the TRICARE North region, (known as Health Net Federal Services). Our region includes Ohio and its surrounding states.

Within TRICARE, there are three separate programs available.

TRICARE Prime is the insurance that most dependents opt to receive. It is referral and authorization based and operates like many health maintenance organizations (HMO’s). You have a primary care manager (PCM) who handles most of your care and makes any necessary referrals to specialists. The advantage of this plan is that all of your care is covered and there are no copayments required as long as you follow their proper procedures about using referrals. It can be tedious but is well worth the effort. I’ve been doing it so long that I’m very accustomed to the procedures.

TRI-CARE Standard is a fee-for-service program that allows you more choice in who you see but also has higher out of pocket costs. Copayments and yearly deductibles are required. Rather than having a PCM, you can often choose which medical care providers that you work with but that depends entirely on if those doctors accept TRICARE insurance.

TRICARE Prime Remote is a program for families that are assigned to overseas military bases. TRICARE Reserve Select are for qualified reservists.

My husband and I chose TRICARE Prime for our coverage because we felt that we could work with a central provider to get the specialized care that I, in particular, needed. Like many IC patients, I have a very complicated health history. Luckily, we’re at a very sophisticated military base which offers a wide variety of care and expertise.

Prescription Coverage

Like other health insurance programs, prescriptions may or may not be covered. Luckily, there are two formularies that may cover your medication, the TRICARE formulary and the base formulary. If a medication is covered by the base formulary, then you can receive for free. If it’s not covered by the base but is covered by TRICARE, they will refer you to a civilian pharmacy (i.e. Walgreens) for the medication. You can also use a mail order pharmacy, Express Scripts. Both of these programs tend to have very low co-payments.

You may also have to use a medical necessity form if your physician feels that a specific medication must be used rather than a medication on the formulary. For example, I am currently using Ambien CR to help improve my sleep quality. The formulary suggested that we use Lunesta but Lunesta gave me severe rebound headaches. In order to get Ambien CR covered, my doctor simply had to fill out the form. It was no problem at all, once I explained the ramifications of taking Lunesta or other alternatives.

Outside Referrals May Be Needed

My bladder symptoms began in 2004, two years before I married my husband. Like many other patients, I thought that I was struggling repeated bladder infections. It wasn’t until I started participating in the military health care system that I was finally diagnosed properly. However, getting there was a journey.

At the time, we were stationed at Keesler Air Force Base in Biloxi, MS. When I first sought care at the base, they had been damaged extensively by Hurricane Katrina thus I was sent to an outside internal medicine physician. She was a wonderful physician who truly listened to me when I explained my symptoms. She did not, however, suggest “interstitial cystitis” as the cause. She thought that I could have overactive bladder. I was pretty tired of my symptoms and desperate for answers. I got online and just googled “pelvic pain bladder urgency frequency” and found the Interstitial Cystitis Network. I felt like this was the answer. My symptoms were identical to those with IC.

I went back to the internal medicine specialist and said I thought that I had IC. She thought that it was possible and referred me to a urologist for a diagnostic workup. The urologist was a hard sell. He mostly worked with men with prostatitis rather than women with IC. It took about a month of seeing him before he would perform a hydrodistention with cystoscopy (under anesthesia). In January 2007, I was diagnosed with IC.

I tried a number of therapies (such as Elmiron by mouth, and Flomax) with no success. Because of my repeated visits to the doctor complaining of pain, I was eventually referred to a pain management specialist who had no clue what IC was. His answer for me was to use four or five narcotic medications which I used for about a year before I was introduced to the idea of using heparin and lidocaine bladder instillations (aka rescue instillations). I was eventually taught to do these at home.

We relocated to Wright-Patterson Air Force Base in December 2007 and that move was a life changing moment in my life as far as my IC is concerned. Given my medical history and diagnosis of IC, I was blessed to be referred to see Dr. Raymond Rackley at the Cleveland Clinic. He is considered one of the best urologists in the country for the treatment of women’s voiding disorders. Luckily, my TRICARE coverage paid for it all because, of course, we went through the proper channels. Like any newly transferred family, we went to the urologist on base first. He quickly said that my case was too complex and referred me immediately.

Specialty Care

In the military, referrals made to outside providers are called specialty care. And, at Dr. Rackley’s clinic, I have truly received compassionate and comprehensive care. I am now much more able to control and manage symptoms using the tips and strategies provided by Dr. Rackley. For example, I did a nine month therapy period of Cytotec (Misoprostol), Heparin and Lidocaine instillation therapies. I can’t say it was the easiest thing to do because it comes with several side effects. I probably would not do this therapy again. What I do now is much less abrasive and much more soothing to my bladder. I do instillations of Elmiron, Heparin and Lidocaine three to four times daily into my bladder via intermittent catheterization.

One of the things that I really like about Dr. Rackley’s clinic is the “group shared appointments.” It might sound invasive to your private information but it is one of the most educational ways to learn about managing your interstitial cystitis. Usually, there are several other patients included and you spend an hour or more with Dr. Rackley and his staff. They give a presentation and then take questions. Dr. Rackley’s nurse practitioner Maria has been my IC angel. She, and his assistant Sally, have been wonderful intermediaries between Dr. Rackley, myself and the military health care system.

Persistence and Education Pays Off

In the military system, it can often be overwhelming to be confronted with this complex and procedure driven system. You have to be persistent and vigilant when seeking health care. And, of course, you have to pay attention to the fine print and details. I encourage anyone with IC working in the military system to ask questions of everyone. And, if you don’t get an answer, keep asking and perhaps consult your on base “Patient Advocate.” Cindy, the Patient Advocate at Wright-Patterson, has been instrumental in facilitating communication between me, my providers and getting the necessary medications and care that chronic IC requires.

Gratitudes

I would like to take this opportunity to say “Thank You” to several individuals who have helped me in my journey with IC. Dr. Rackley and his team have been superb. The urology clinic at Wright-Patterson has been very helpful in responding to my emergencies. Unlike other specialists, they have no problem contacting Dr. Rackley’s office if they need additional information. The Patient Advocate at Wright Patterson, Cindy, deserves huge accolades for her care and assistance.

Last but certainly not least, my husband Aaron is the love of my life. Even before we were married and I was struggling with IC, he was always there for me. He was even ever-present when I was struggling to learn how to self-catheterize. To Aaron, I want to say that I love you, all the world, to the moon and back, and with every fiber of my being. There are not enough words to express my gratitude for your constant support, love and understanding.

I am on the ICN frequently and available by email at aprilannchen@gmail.com.

[Snowden1]

April,
Thanks for this info. My husband is also in the military and will have 20 years in this year. He was going to retire (20 was enough for me), but now we really need the healthcare benefits (since I had a hysterectomy/infection while stationed in MI which led to IC). I wanted to add that my husband told me that they will soon be eliminating Tricare Prime. We have always chosen Tricare Standard and I'm glad we did. We have hardly ever been stationed near a military base. In addition, I don't have to get referals to see specialists. We will once again be moving back to Virginia this summer. Although, I'm not sure how long we will be there. This is a 4 year assignment, but if my husband makes 06 we will have to move again in 2 years. It makes finding good IC doctors difficult and maintaining consistant treatment difficult because we are always moving. I just found a pain management place here and now I am calling ahead to find urologists etc in Virginia. The good thing about Virginia is that there are many military people stationed there, so most offices understand Tricare, (how it works) and most of the doctors take it. My husband and I also bought a supplement to Tricare that covers what Tricare doesn't cover. I have been really happy with it. If Tricare pays on a claim it will pay the rest, even if Tricare only pays $1. All Tricare has to pay is something and our supplement will pick up the rest. We don't have any co-pays. We do have a deductible that is very reasonable. The supplement has been well worth the small amount we paid for it. Tricare has greatly improved since we first got in the military, it was called "Champus" then and we had a terrible time getting them to pay anything. Now, however, it is so much better. From one military spouse to another, thanks for the info and good luck on your next move (they come so fast now).:dizzy: Oh, I also wanted to add that I'm also a former teacher. We have many things in common.

[nottoc4]

My husband was in the Navy for 30 years and is retired and over 65 years old. We have TRICARE FOR LIFE,which is great.

We have to pay Part B of the Medicare and then Tricare For Life kicks in and there are no co payments. We do NOT need a referral for anything and get our prescriptions free at the Naval Hospital on Camp Legeune,NC if it is available. If we have to go to an out side pharmacy we have a co pay of $3 for Generic,$9 for name brands,$22 for certain medicines.
My Elmiron costs $9 for 30 day supply. My husband has cancer and has had 2 surgeries,radiation and chemo that he is not done with yet.Once a month he has to have a drug Neulasta in shot form and the cost of it is over $3900.00
He pays $22.00 for it.
We have not had to pay for any treatments,Dr. visits,tests,and will not have to.
Free healthcare for life is a wonderful benefit for retirees,and they earned it.
I wish everyone had such good coverage. It's something we don't have to worry about.

[Snowden1]

Hi nottoc4
Oh, my mom and step-father now have TRICARE FOR LIFE. My step-father is retired from the Army after 30 years, and your right, after all of that they deserve it. I am so sorry to hear that your husband has cancer. I am glad though that you get your meds so easily and that they are inexpensive. You are in NC? Just wondering how far that base is away from Chesapeake, VA? I am going to see Dr. Evans in NC in July and wonder if that base would be on our way? Thank you for all the information. It is good to now that we will have this when we retire (if the government health care stays at is now). I know that I have already seen more doctors in the last year and taken more meds than I ever have in my life. At least I feel better knowing that as of now we won't go broke with healthcare costs. I used to be a teacher and we really miss that extra income that I used to make. I don't know that I will ever be able to do that again in the shape I'm in now. I pray that your husband and you get well.

[nottoc4]

I think Dr. Evans is near Greensboro and High Point on I 40 West from here.
If you come North on I7 t0 get to I 40W you will pass through Jacksonville and Camp Lejeune.

[Snowden1]

Hi,
Thank you, very much. I ask my husband about it and he is familiar with that area. I am not at all. Hoping Dr. Evans can help me, though. How do you like NC? Have you lived there long?

[nottoc4]

I've lived here since 1985 and I love it here. I was born and raised in Pittsburgh Pa and left there in 1978 for job reasons .

[babygirl1071]

I was in the Navy for 6 1/2 years. I was about two months from my seperation date when the whole IC thing started. The docs kept giving me the run-around telling me it was repeated UTIs, yeast infection, and even herpes. I really think that because I was so close to my seperation date that they just basically said "sorry, we can't help you". I am glad that the rest of you have had better success that me.

[CarolinaGal]

Tricare has been so good to my husband and I with all of his medical bills. I don't know what we're going to do without it.

North Carolina is a nice place to live. :) The hubs & I plan on staying right where we're at. We're close enough to the base that we can utilitize the PX and commissary if we'd like, yet we're far enough away that we aren't surrounded by Marines (unless the hubs has his friends over).

[SemperFiBabe]

asdasd

[CarolinaGal]

My husband is getting kicked out of the USMC because of IC so you are lucky to be able to stay in SemperFi. They began his discharge paperwork as soon as he got a diagnosis because IC is a medical disqualifier. :cussing:

[Linda May]

I am so thankfull to have insurance, but its so sad that so many people suffer or die because they don't have insurance. I love the U.S.A. I live in Alabama and have IC but the health care system for the poor is a disgrace.
A friend of mine died a long time ago of an anursym but he did not have insurance they would not see him , you know how you have to pay up front or wont be seen.:angel:

[JeanAnn56]

Babygirl, I was in the Navy too....they told me i had no rights after separation...they are WRONG!!!! I am now a disabled Vet not ic related...they take care of my ic....
if you have proof that you were having symptoms when you were active the HAVE to take care of you and they HAVE to pay you for it monthly. Get a copy of your records, and take them to your local DAV. Have them put in for disabilitiy....it took me 4 years to get them to admit to my service connected injuries (knee and back). They finally did and i got back pay from when the date i put my claim in. Be persistant and dont take no for an answer. ANYTHING that you had and still have problems with while on active duty they are responsible for your care for the rest of your life.

Jean ann

[luvsterriers]

My husband is getting kicked out of the USMC because of IC so you are lucky to be able to stay in SemperFi. They began his discharge paperwork as soon as he got a diagnosis because IC is a medical disqualifier. :cussing:

You can get kicked out of the military due to a medical condition?? I didn't know that. :( My dad is retired US Army. He retired as a Lt Colonel.

I know that with adult children Tricare covers until age 23 IF they are in college full time, but now it covers till age 26. I was a full time college student for 5 years. I miss Tricare :( I know of a young woman who is 33 years old, unmarried, and has a child but STILL is under Tricare. No clue how she got that. Her dad is also retired US Army as well. She doesn't have any disabilities like IC or autism. I read something on Tricare about autism. I don't know if I can qualify. I have aspergers and learning disability. Maybe the young woman has Tricare still because she's not working?

[Snowden1]

Hi, I have Tricare Standard. You can for sure get kicked out of the military for health reasons, my husband has high blood pressure and really has to watch it. We extended beyond 20 years, but hope to retire in three more. Then we will go on Tricare for life. For retired people.

I see you live in Fairfax, VA. We are supposed to be moving there in June of this year after my husband is done with this military school. Could you PM me and let me know where to go for IC related things? And where the best places are to live?

I don't know how that lady got Tricare unless she was married to someone in the military and divorced. I don't know if Tricare will cover someone that old under a parent (unless there is some kind of disability or something).

[JeanAnn56]

"kicked" out on a medical discharge, you are considered a disabled veteran and are entitled to compensation for life. He should be able to get all his medical and he should get some monumentary compensation monthly.

Jean ann

[zyphia]

I too am curious about the term *kicked out*. Did you mean discharged but your husbands didn't want to be discharged or did you mean medically discharged or discharged with a disability rating? I think *kicked out* is a rather harsh term. My husband was honorably discharged from the Air Force after 20 years service with a small disability rating but he chose when to retire, they did not choose for him. I was 39 when he retired and he had a job in the civilian workforce that provided us with excellent health insurance and we used Champus (now Tricare) as our secondary. When I became disabled at 59 I went on Social Security Disability and began receiving Social Security payments, Medicare, Tricare for Life. and only paid the premium for Medicare B (hospitalization) and no Tricare premiums. We have never paid a Tricare premium. I have accrued a little more than one quarter of a million (yes ONE MILLION) dollars in medical bills since 2002 and have only had to pay about $300 in out of pocket expenses. Tricare has worked very well for me.

[Snowden1]

I am sorry if the term "kicked out" upset some people. It was not my intent to cause a stir. I was in the military for 6 years and received an honorable discharge when I left. My husband does have benefits from Tricare Standard currently (our whole family does because he is active duty). Tricare has been wonderful in covering my many bills I know have with severe IC. We also pay for a secondary insurance (MOAA - Military Officers Association) to pick up what Tricare doesn't allow - this is also called Mediplus. My husband has always had high blood pressure to a certain extent. He also has "white coat syndrome" where his blood pressure gets crazy around doctors. My husband is an 0-5 and wants to make 0-6. The difference in pay between these two for retirement is significant. So, when I say kicked out - I mean medically discharged and not make his next rank and retire with significantly less pay. Yes, he would get some disability pay. My step-father retired as an 06 (Colonel) in the Army with a disability and receives money for his disability monthly. (The pay is determined by the disability and some other things). Both, my mom and he are now on Tricare for life (which pays well, but not what active duty Tricare Standard pays for us currently). My step-dad currently works for government and draws his retirement pay plus a 5% disabilty pay portion).

We NEED my husband to continue to support our family, my oldest daughter is in college, my youngest will someday need to go to college, and I need the medical benefits because of this illness. If my husband were to be medically discharged for any reason he wouldn't make his next rank to retire at a place where we could actually live somewhat comfortably. I grew up in the military, my husband's father was enlisted in the military, I was enlisted as well, my husband went in the military as an officer and my step-dad retired about 10 years ago. I was in the military, I was honorably discharged but, there is no retirement for me because I didn't go through a full 20 years.

I guess the point I was making was for me and my family personally. My husband wants to retire at 06 pay so that he can stay home and take care of me and not have to jump into another job. We have added up the numbers all the way around and him staying in to reach this goal is extremely important to my kids' future as well as being able to help me more with my daily care needs. I want my husband's health to be remain optimal. I know he has so much stress from me and this condition and I know it impacts his health as well as my kids (who are in counseling to help them with seeing me in this contant pain).

If my husband where to be discharged for medical reasons (it depends upon the reason) he would not have a choice to continue service. As a side note, unless you have 18 years of active duty you may not receive full retirement, you may just receive severance pay and some disability.

One of our friends for example, a petty officer, who developed type 2 diabetes. He was sent to a medical review board and discharged, because he was not fit for world wide deployment. He doesn't receive a "monumentary" check, but does receive care from the VA hospital. He still has to work another job to support his family. The rules are different for each service, but normally you need 18 years of active duty service to qualify for full retirement benefits. My husband is not totally worried now about having 20 years of active duty because he just made that this year. He doesn't want to be like his dad, though, retired but still having to work for the rest of his life at another job.

Things have changed dramatically since 20 years ago in the military. They are now considering NO retirement benefits until age 65. MOAA and other military organizations are continually trying to lobby to keep what we have for medical benefits. We have Tricare Standard and we pay $300 per person for premiums so that we may see any doctor of our choice. If we had Tricare Prime we would pay nothing, but would not be able to choose our own doctors. It is up to each family if they want to pay the extra or go with the Prime option. The military is now in a rif (reduction in force) - the first people they look at eliminating are those who are on disability who are not considered deployable.

Because my husband accepted this assignment at the Army War College for another Master's degree he is now obligated for 3 more years of active duty. It is then our hope that he will have made 06 and we can retire comfortably so that he doesn't have to work but can help me now that I am disabled. I did not qualify for disability because I was a teacher and didn't pay into Social Security and didn't have enough credits in the right years. Also, my husband makes too much money for me to qualify the other way. We have checked into it extensively. Nevertheless, we still have kids and college and bills and no income from me anymore.

I hope this puts to rest this subject as I didn't realize my choice of wording was upsetting anyone. I had no intent to stir up issues. I was not trying to disrespect anyone or the military in anyway. So, I hope this explains my thought process better and we can just discuss IC at this point. Thanks :)

[zyphia]

Now I feel bad..I feel as tho I have upset you... but that was not my intent. I was just concerned about the use of the word *kicked out*, because, as I stated, of its harshness. To me that denotes wrongdoing on the part of the serviceperson. It was nice of you to fully explain, altho it was not necessary to go into such detail. I hate for you to have to have spent so much time. I do know that things have changed in the retirement system since my husband retired in 1980. He retired after a little over 20 years with about 55% of his base pay. We live a comfortable life down here. We chose to retire back to the homeplace, in the rural south, away from the hustle and bustle of the city and are on 100 acres of farm/woods land and the children are both gone and with children of their own, a son nearby and a daughter about 120 miles away. I wish you good health and your husband too. The transition from military life to civilian life was very easy for us and we just took it a day at a time and never worried about tomorrow for we always knew that there was that chance that tomorrow might not come. We live for today and enjoy every moment we have together. We are very fortunate that my husband is a healthy and robust 72 year old who has no health problems at all, having served several tours in Vietnam (and exposure to Agent Orange), Korea, Okinawa, Guam, the Philippines, and Germany. I am truly blessed. Life's a dance.....you learn as you go.

[luvsterriers]

I found this article in the armytimes. Very interesting.


My son will turn 23 just three weeks before he graduates from college. Is there any way his Tricare eligibility can be extended until graduation? Surely three more weeks wouldn’t be noticed in the federal budget.

A. Eligibility cannot be extended beyond age 23. Federal law requires his eligibility to end if he marries, graduates or turns 23, whichever comes first. The only exception is if he is incapable of self-support as a result of a medically determined physical or mental disability. If you believe that to be the case, call the Defense Enrollment Eligibility Reporting Service at 800-538-9552.


For me, I can't own my own home. When my parents bought a house in Seattle for investment, we all went to Wells Fargo. I think it was something to do with mortgage. I listened in and was so confused. I know nothing about budgeting and taxes. We actually have someone do our taxes once a year. I know when I get a bill in the mail or emailed to me, I know to pay the full amount. But I would be overwhelmed with issues having to do with owning a home.

Issues like plumbing problems, AC/heater not working, gutter replaces, lawn service, termite control, roof leaking, etc. I know there are people with aspergers who are ok and are married and have kids. I couldn't manage being a mom and a wife. Sure, I dated a man in my 20s but relationships is too much for me to handle. I can't even cook a nice meal. I don't know what I'll do once my parents aren't here. I still live with them. I would be lost without them. So I don't know if my aspergers qualifies me for Tricare for life. Oh yea if I had car issues and the tech explains to me I am clueless. I have to have dad explain to me. Perhaps if I had a brother around my age it would be helpful to me.

[zyphia]

This is copied from the AZCentral.com web page Jan 7, 2011...News and Information web page. It clearly states the chang in health care for children of active duty and retired service personnel.


WASHINGTON - Defense Secretary Robert Gates is betting that Americans' frustration with a ballooning deficit will finally allow him to trim one of the government's most politically protected entitlement programs: the military's $50 billion-a-year health care system.

The defense chief has tried to push similar proposals through Congress before and failed. And this year's pitch is a particularly fraught with political risk. President Barack Obama is defending his own health care plan from threats of repeal in the House, while Republicans are looking for ways ahead of the 2012 election to discredit the administration's commitment to the troops.

Last month, Congress voted to extend coverage of children of service members and retirees until the age of 26, putting the program in line with new requirements for civilian policies.

Gates' proposal, announced this week, appears relatively modest. It would raise fees only on military retirees under the age of 65, who presumably have access to health care in their civilian jobs in addition to their military pensions and haven't seen a rate increase in more than 15 years. Meanwhile, health care for active-duty troops would remain free and rates charged to older retirees would remain untouched.

[CarolinaGal]

Kicked out .. discharged .. anyway you put it he is being forced out. Whether or not he gets disability is up to the panel that processes his package and right now we don't know that much. We're *praying* he gets things under control so he can stay in because that man loves the Marine Corps.

[jessicarr9]

I just stumbled upon this thread! I am a military spouse too (Marine Corps) with IC and a condition called Diabetes Insipidus. (My body doesn't process water properly). Tricare has been a blessing in that it covers everything, but we've had to fight long and hard for me to receive proper care. It's been an uphill battle since I was diagnosed in 2005.

[zyphia]

Interesting you should mention the diabetes insipidus. I was diagnosed with that back in the early 70's because of the frequency of urination and thirst, and my signs and symptoms are eliminated by treatment with a modified from of vasopressin. Anyway, I am sorry to hear it is so hard for you to receive proper care for your IC. Don't give up the fight and don't be afraid to fight...ever! I started fighting with Uncle Sam in the early 70's and am still fighting with him and so far I have won every battle.

[CarolinaGal]

I, personally, think TRICARE is really good insurance. We have Tricare Reserve Select which is pretty similiar to Standard and the only problem I've ever had is with the eye doctor.

For the past year though my husband has gone to the doctor at least 5 times a month and thanks to TRICARE we only had to pay our $1,000 deductible - which saved us tens of thousands.

Their customer service is iffy at times, but as far as coverage and co-pays (or lack thereof) you can't beat it.

[luvsterriers]

Dad sent out info about my aspergers and LD to whoever at Tricare, still waiting back any response. It may take a while, but thats ok. IF I can get Tricare I am planning on working on the military base close to where we live. That would be wonderful to get Tricare AND work at the hospital on base.

[gsd715]

This is copied from the AZCentral.com web page Jan 7, 2011...News and Information web page. It clearly states the chang in health care for children of active duty and retired service personnel.


WASHINGTON - Defense Secretary Robert Gates is betting that Americans' frustration with a ballooning deficit will finally allow him to trim one of the government's most politically protected entitlement programs: the military's $50 billion-a-year health care system.

The defense chief has tried to push similar proposals through Congress before and failed. And this year's pitch is a particularly fraught with political risk. President Barack Obama is defending his own health care plan from threats of repeal in the House, while Republicans are looking for ways ahead of the 2012 election to discredit the administration's commitment to the troops.

Last month, Congress voted to extend coverage of children of service members and retirees until the age of 26, putting the program in line with new requirements for civilian policies.

Gates' proposal, announced this week, appears relatively modest. It would raise fees only on military retirees under the age of 65, who presumably have access to health care in their civilian jobs in addition to their military pensions and haven't seen a rate increase in more than 15 years. Meanwhile, health care for active-duty troops would remain free and rates charged to older retirees would remain untouched.

too bad its not in effect yet. My sis-in-law is 1 quarter away from graduating with her Bachelors but will turn 23 before she can finish, F-I-L is retired AF.

I have Tricare Prime and love it. My doctor on base doesnt question me when I ask for a referral having to relate to my IC. Tricare covered by InterStim surgery, all nerve blocks, etc.

[0650]

I currently have Tricare Prime and am having issues getting PT for pelvic floor muscles approved. Do you have any suggestions for me? My PCM has put in two referrals, I ended up seeing a UroGyn in Savannah, and now have been told I could have IC along with weakened pelvic floor muscles and vulvodynia. (dx'ed in March, 2009 and May, 2010 before I was with Tricare) I was told no one is in the area to help me with PT and I am worried I will have to move back home to our home state to get my medical needs met.

[zyphia]

It is very difficult for me to give you advice...I am Tricare 4 Life and it is, I must admit, a lot different than Tricare Prime, no matter what anyone tells you. Plus, I am on Medicare and am a grumpy old lady and there is not a doctor alive who wants to mess with a grumpy old lady so we usually get what we want so they can get us out of their hair. Hard to believe but a fact. I used to be a nurse so know these things. My only suggestion would be to write letters and complain. I am a letter writing complainer and it has usually worked for me in the past. If you have am EOB from Tricare get some addresses from it and begin to write some letters to some of the addresses on there and explain the problem. Write some letters to the people who are head of Tricare, explain the problem. Of course they won't read the letters but along the way someone will, someone below them. Include information about IC, let them know, make them aware, of how painful IC is. Write anyone you can think of...even your Congressman...I once wrote a letter for a friend because her husband was not getting his proper veteran's benefits and after only 2 letter writing campaigns he got what we asked for...we just had to hit up the right office. Don't give up..you may feel like a fool at times but don't give up.

[suzannes]

I live in Alaska and have TriCare Prime. I have been seeing a Women's Health PT off base for 1.5 years now with great success. First go to the Physical Therapy Association web page and you can search for PT in your area who specialize in pelvic floor dysfunction. I was luck there are only three in the state of AK and the one I use is close by. Hopefully the PT in your area takes TriCare, most do out of a sense of duty for military families. Your PCM needs to put in a request for services for off base care. It usually takes 2-3 days to get approved. I'm retired AF so my c0-pay is $12. If you are from an AD family there should not be a co-pay. I'm a retired AF Nurse Practitioner and know the system pretty well. Feel free to contact me if you have questions.

Suzanne

[zyphia]

0650.......there ya go.......that should help you...suzanne's right in the middle of it all. Oh and by the way, I notice you are in Georgia...well if you are anywhere near Atlanta there are some great doctors in the area who are now doing specific GYN/IC care for women. It is wonderful. Two years ago I had to have major surgery for something not at all concerned with my IC and it was flaring so bad that my GYN fellow and my urologist who did specific treatment to get it under control and I have not had one flare up since then. I have turned off my neurostimulator and it is as if I was never diagnosed with IC. I am loving it. Am in the process of planning a vacation in Europe with my family for May too. Life is good. Hang in there.

[lisa7688]

I've had pretty good luck with the military health care system. Since I didn't like any of the doctors in the area we moved to a few years ago, I just dropped my blue cross/blue shield and I go to the clinic on base. None of the NPs or Doctors seem to be very familiar with IC but they have been really interested in what I have to say about it. They ask me questions about it and if I needed a referral for any issues with my IC I feel comfortable that they would help me out with that. Last time I went to my Gyno she asked me several questions and wanted to know about this website due to another patient she suspects has IC. I was happy that she was interested in learning more and helping this patient get the proper diagnosis.

I am able to manage my IC on my own with diet, aloe vera, etc. so I haven't needed care related to my IC while in the military health system. I do feel confident that I would be able to get what I needed should I have problems with a flare and need a certain prescription or referral, etc.