Well all I got the answer to my final appeal on Friday (how they manage to have it arrive on a friday is just amazing). Of course the answer was NO again, and the last page of the 19 page denial said that I could not appeal again. So, now I start the process to go to Madgan Army Hospital to have my ADR done there. I have to make an appointment with the surgeon, I have to make the appointment 14 days out because I have to fly to Seattle and the price of a ticket without the 14 day advance is out of the question. So hopefully I can get an appointment on or around the 6 Sept. if I get an appointment before 19 Sept then my mom is going to go with me, because my parents are coming out (My dad mostly) to help build my daughters house. The amazing thing is I was not even upset about getting the denial, I knew it was going to be a no when I sent it in. Right now I just want to go to Seattle and get things started so I can to the part of this where I get to start my new life. Cathy

How is it that Tricare is denying the request but the military will do the ADR? I am USN retired and have tricare as my secondary insurance.

Cathy,
I'm very sorry your final appeal was denied. I too don't understand how a military insurance co can deny a procedure that is done at a military facility!

Do you know approximately what your final cost will be? Is it less because it's at a military hospital or are costs similar to civilian hospitals?

I wish you luck.

Dale

Sorry, Cathy. I wish there was something I could do.

http://adrsupport.org/groupee_common...icon_frown.gif

It sounds like you are on the right path though, keep following the path you know is right for you...

The reason that Tricare won't pay for the surgery and I can have it done at a military hospital is because they are two different worlds. The reason that I can have it done at madgan is because the doctors need to keep their skills sharp for the men coming back from the middle east. The only cost that I will have to pay out of my pocket is the plane ticket for the consultion, I will be staying at the base hotel which is alot cheaper then downtown, I will have to rent a car at the airport, and pay for food while I'm there. When I go for the actual surgery, hubby and I will be driving stopping at fairchild air force for the night and then on to Madgan. Which we will have to pay for all travel expences any time we go to Madgan. The surgery and all the tests pertaining to the surgery will be paid for by the government. Right now a round trip ticket to seattle is running 255.00, I don't know about what the rental car is going to run. Hopefully this first trip should be under 500.00. The one that will cost the most is when I have surgery. I want to thank everyone for their replies. Cathy

Cat
Sorry you got turned down again but am very glad you can have the surgery done at the Military base. That has to be a sigh of relief that you will be able to get the care you need one way or the other.
Insurance companies really really STINK!
Will be sending up healing thoughts for you.
Please let us know when you get scheduled!