Please help!

March 4, 2010 4:43 PM

Can a new US Army active duty dependent go to a military hospital emergency room for free?

My daughter's husband has just joined the Army and is at basic training. She has a history of tubal pregnancies and is now showing symptoms again. She has just (like two days ago) signed up for Tricare Prime which will not be in effect until April 1. She says she is presently in Tricare Standard until Prime becomes effective meaning that she would have to pay to do this, but that doesn't make any sense to me. He is active duty, he is entitled to benefits, what's the holdup?

I have read through the Tricare book and it is just like reading a foreign language to me, and I'm in the health care field no less.

Her father and I did 15 years in the Army and never had to deal with this. The answer was simple, "yes."

So... If she goes to a military hospital emergency room, what would she expect to pay? It had better damn well be free. That's the way it has been for eons and if her husband can die for this country, she had better be taken care of.

Anyway, thanks in advance for any answers.

posted by magnoliasouth to Grab Bag (14 answers total)

Did you call the insurance company?
posted by Think_Long at 4:49 PM on March 4, 2010

Response by poster: Oh and by the way... her PCM is unavailable. There is no on-call person designated either. We are at a loss on what to do here.
posted by magnoliasouth at 4:50 PM on March 4, 2010

Response by poster: Everything is closed.
posted by magnoliasouth at 4:50 PM on March 4, 2010

Can she just show up at the closest military hospital with her dependant military ID card and have them check on her DEERS enrollment? I believe that would tell the people at the hospital what coverage she has.
posted by MsKim at 4:55 PM on March 4, 2010

Oops...forgot to add that if she thinks she is having a tubal pregnancy it is most important to get medical attention ASAP and figure out the financial situation later.
posted by MsKim at 4:56 PM on March 4, 2010 [1 favorite]

Response by poster: It's not a question of coverage. She is definitely DEERS enrolled. She also has Tricare Standard until Tricare Prime goes into effect. I'm just wanting to know if she can go to the military emergency room and get treatment, without getting a bill.

Sorry if I didn't make myself clear. I'm just very frustrated right now because I can't find the answer, all the offices are close and she can't find help.
posted by magnoliasouth at 4:58 PM on March 4, 2010

If she's having symptoms of a tubal pregnancy, get her to the ER and worry about the red tape later. I doubt she'll get a bill (she's the dependant of an active duty soldier and she's going to a military hospital -- the Tricare Standard/Prime differences probably only apply to civilian medical facilities, but I'm not certain about that). But, even if she does get a bill, you can deal with it after the fact. The most important thing right now is for her to get medical attention.
posted by amyms at 5:10 PM on March 4, 2010

My advice is go. I got my front teeth fixed once by the Army even though I was in no way entitled to be seen; they got busted out by the Army, though. Two dentists took a look at me, fixed my teeth and handed me back my incriminating records as I was leaving.

I'd go and explain the situation.
posted by atchafalaya at 5:11 PM on March 4, 2010

Best answer: Under Tricare standard, her cost would be 20% of the overall cost of the ER visit. Here's the breakdown currently in effect. I'm Active Duty not a dependent so I'm not sure how they charge at a MTF these days. I don't know where she is but she can use this form to find her nearest MTF and they'll have a contact number she should be able to call to get more information.
posted by macfly at 5:15 PM on March 4, 2010

Tricare has agents on duty 24 hours a day. Go to the Tricareonline website and call the number for the region that covers your daughter and talk to those guys.

I am a military spouse (my wife is retired active duty navy), and we have Tricare Prime and I have never heard of a military hospital charging a dependent - I don't even think they are set up to collect fees. If she has a dependents ID card she should show them that and let them sort it out. I think it is unlikely they will refuse to treat a military dependent - so long as she has her ID card to prove she is a mil. spouse. On the back of my ID card it says Medical: Direct Yes and I think this shows you are entitled to medical services.

There may be some payment involved down the road as Tricare is insurance and we have to pay our premiums like any other insurance plan, but I would start with calling the region she is in for advice.
posted by 543DoublePlay at 5:17 PM on March 4, 2010

It doesn't matter what the answer is. She should go to the nearest emergency room NOW and worry about whether it's covered by her insurance later. The death rate from ectopic pregnancy is about 1 in 2000. Again, I repeat, EMERGENCY ROOM NOW.
posted by decathecting at 5:21 PM on March 4, 2010 [3 favorites]

Ectopic pregnancy can kill - sort this out later, ER now.
posted by tristeza at 6:16 PM on March 4, 2010

Response by poster: Thanks all. I'm actually a nurse and I've even worked as an OB nurse. I really do appreciate the medical advice, but my question was about the insurance and the money. I mean that genuinely and not snippy. Hopefully it doesn't sound that way.

In any case, the 20% is what we needed to know. Thanks much all!
posted by magnoliasouth at 6:24 PM on March 4, 2010

Sorry I'm late to the thread - but there should be NO CHARGE for a family member of an active-duty servicemember being seen and treated at an on-base medical facility.

A co-pay would likely be required for that person to be treated in a civilian emergency department, but not a military hospital.
posted by davidmsc at 8:38 AM on March 5, 2010