Below are details about getting TriCare to pay for travel expenses to attended a medical appointment:

http://www.tricare.mil/Factsheets/viewfactsheet.cfm?id=181

TRICARE Prime and Non-Medical Attendant Travel Entitlements

Under provisions of the 2001 National Defense Authorization Act, TRICARE Prime beneficiaries referred by their primary care manager for services at a location more than 100 miles from their PCM may be eligible to have their “reasonable travel expenses” reimbursed by TRICARE. The travel reimbursement entitlement is retroactive to Oct. 30, 2000.

Eligibility for the TRICARE Prime Travel Entitlement:

The TRICARE Prime travel entitlement is available to non-active duty TRICARE Prime enrollees and TRICARE Prime Remote family members when they are referred for medically necessary, non-emergent specialty care more than 100 miles from their primary care manager location.  The “greater than 100 mile rule” is stated in statute and isn’t negotiable when determining applicability of the Prime travel benefit. 

Beneficiaries must have a valid referral and travel orders from a TRICARE representative at the military treatment facility where they are enrolled or from their TRICARE Regional Offices if their primary care manager is a TRICARE network provider. 

Note:  This entitlement doesn’t apply to expenses experienced by active duty uniformed services members, or active duty family members living with their sponsors overseas, which are reimbursed by other travel entitlements.

Reasonable Travel Expenses:

Reasonable travel expenses are the actual costs incurred by beneficiary when traveling to their specialty provider-not in an emergency status. Costs include meals, gas, tolls, parking, and tickets for public transportation (i.e. airplane, train, bus, etc.). Beneficiaries are required to submit receipts for all expenses.

Government rates will be used to estimate the reasonable cost. Beneficiaries are expected to use the least costly mode of transportation. The actual costs of lodging (including taxes and tips) and the actual cost of meals (including taxes and tips, but excluding alcoholic beverages) may be reimbursed up to the government rate for the area concerned.

General Process for Receiving Travel Reimbursement:

If the beneficiary is referred by a provider at a military treatment facility, he/she should contact a military treatment facility point-of-contact for a briefing on the entitlement process and beneficiary responsibilities.

If the beneficiary is enrolled to and referred by a civilian primary care manager, he/she should contact a point-of-contact at the TRICARE Regional Office.

Beneficiaries must obtain official travel orders from the military treatment facility or TRICARE Regional Office point-of-contact.  Beneficiaries will be required to make their own travel arrangements unless the military treatment facility or TRICARE Regional Office point-of-contact arranges for government travel. Beneficiaries are required to coordinate their own lodging arrangements.

Upon completion of travel, the expenses need to be itemized on a SF 1164 or a DD1351-2 (travel voucher) and receipts are required for all expenses.  The military treatment facility or TRICARE Regional Office point-of-contact will provide the beneficiary with specific instructions on how and where to submit his/her travel entitlement claim.

Traveling with a Non-medical Attendant:

The FY02 National Defense Authorization Act authorizes one parent, guardian or another adult family member to travel with a non-active duty Prime enrolled patient as a non-medical attendant. The non-medical attendant is authorized reimbursement of actual travel expenses. If the non-medical attendant family member is an active duty service member authorized by the military treatment facility or TRICARE Regional Office to accompany a non-active duty TRICARE Prime enrollee as a non-medical attendant, he/she is entitled to TDY allowances (per diem and mileage), not actual expenses.

If the non-medical attendant family member is a U.S. Government civilian assigned to TDY by their civilian organization, they may also be entitled to TDY allowances.

By statute, the non-medical attendant must be a parent, legal guardian or other adult family member. However, if the non-medical attendant isn’t the parent, the non-medical attendant must be at least 21 years of age. The non-medical attendant isn’t required to be enrolled in TRICARE Prime or to be TRICARE-eligible. The patient, however, must be enrolled in TRICARE Prime.

The uniformed services and the TRICARE Regional Offices have responsibility for implementing and managing the non-medical attendant provision. The non-medical attendant benefit is retroactive to December 28, 2001. Non-medical attendants that qualify for reimbursement under this entitlement should save their travel receipts.

For more information about the TRICARE Prime travel entitlement, please contact the local military treatment facility or TRICARE Regional Office beneficiary counseling and assistance coordinator or travel point-of-contact. Telephone numbers and addresses for BCACs are available on the TRICARE Web site at http://www.tricare.mil/contactus/.

Much has changed in our lives over that last two years. Travis has retired from the Marine Corps. We moved out of our old apartment into the one that we are living in now. Travis had CyberKnife radiation. Victoria started middle school. We received AMAZING NEWS that Travis’ pesky Schwannoma tumor succumbed to Dr. Adler’s treatment. NO MORE TUMOR!!!! I started back at work and went back to college.

Travis accepted his dream job at Northrop Grumman. He entered through a wonderful program called Operation Impact. Since retiring from the Marine Corps. Travis has been seeing new doctors. He struggled through Methadone withdrawal and is now 100% METHADONE FREE. He has a prescription for Vicodin to use for breakthrough pain but he has not taken any since June 30th. He has come a long way from his daily doses of 3000mg of Neurontin and 10mg of Methadone.

Our offer was accepted on our first home. (We are in escrow right now.)

Travis came down with Diverticulitis and then suffered from a secondary infection as a result of the antibiotics given to him to treat the Diverticulitis.

So much has happened over the last two years.  Life sure has not been easy but things seem to be turning around.  We are learning to see the glass as half full rather than half empty.  I expect that we will continue to face hurdles but what I have learned is there is nothing that Travis and I cannot accomplish if we put our hearts into it.

I am not sure what to think about the extra treatment.  As soon as we found out about the second treatment Travis called and left a message for his surgeon to get the details.

I will update as soon as I have more information.

Travis has known Doc for years, way before he was diagnosed. Travis has always spoken highly of Doc and I learned why. This man is a WONDERFUL doctor. He is not only extremely knowledgeable but also very dedicated and caring. Doc was there for us every step of the way. He gave us lots of advice, he went with us to meetings, and was always available to take a call. He listened when we needed to vent and always gave professional advice.

Doc went way above and beyond and was one of the most valuable parts of this chapter of our life.

So much has happened since I last wrote. I will do my best to recall the important stuff.

Friday, July13, 2007 was surgery day. I had a lot of confidence in Dr. Adler but I was still so scared. Even though I should have thought of positive things all I could think about was losing Travis. His first surgery was 11 hours and I felt so luck for him to pull through it. So back to the 13th, the surgery went really well. It was completed in 4-5 hours which was less than half the time of his first surgery. After surgery Travis was wheeled by us as we waiting in the waiting area and he looked better than I expected him to look. He was not nearly as swollen as his last surgery.

Dr. Adler told us that he was able to remove more of the tumor than he initially expected and that he took out about 90% of the tumor. This was great news.

Travis was in the ICU over night and did great. On July14th Travis was transferred out of ICU and put in a regular room. Travis did so well the next few days. His pain was minimal and his swelling was going down by the day. On Monday July 16th Travis was released from the hospital. Travis was doing well except for a side effect from one of his medications. Decadron was used to help reduce the swelling but it ended up also causing Travis oral thrush. We made a trip back to Dr. Adler on Tuesday July 17th and Travis was prescribed Nystatin to treat the thrush.

As soon as we returned home from the hospital Travis was complaining about his back hurting. I went out and got him a heating pad and he sat on it for the next few days. I suggested making a trip to the emergency room but Travis did not want to.

By Sunday July 22nd Travis could not walk because his back hurt him so bad. At 10:00pm we went to the emergency room at Stanford. They started him on an IV, gave him pain medication, took blood, urine, and did an x-ray of his back. After all of the tests the doctors could not figure out what was wrong. Travis did not have a fever. They wanted Travis to get an MRI but they said the soonest he could have one would be at 7:00am the following morning. Travis and I squeezed together on the gurney and tried to get some rest.

The sun rose and it was now Monday, July 23rd. Travis had his follow up appointment scheduled with Dr. Adler at 9:00am. Around 7:00am Travis went downstairs. While I was waiting in the MRI waiting area I met two other families who were also there because one of each of them also had a brain tumor. I know this may sound wrong but it feels good to meet people who are going through what we are. I would never wish this disease on anyone but at the same time it feels good not to be alone. Friends and family can be very supportive but meeting people who live with what you do offers something else.

After the MRI was done we were taken back to the emergency room to wait for the findings. The neurosurgeon on call came and spoke with us. Something was seen on the MRI. She was not sure what it was but she said that it was large and that it could be another tumor, possibly another Schwannoma. When she explained this to us I did not even want to look at Travis. That was the last thing that I wanted to hear and I hated to imagine the pain and fright that was going through Travis’s mind. That news killed me. After feeling that the second surgery was a success the heavy depression was lifted off of my shoulders. The last year had been so difficult. Everything was day by day. We could never plan for the future because never knew what was already planned for us. When Dr. Adler told us that he removed more of the tumor than he expected, all of my hopes and dreams for the future had been restored. I felt like Travis and I had finally beaten this nasty game. Days later when we were told that there was a large mass of “something” on his lower spine (T-1 and T-2) I felt like our future and our happiness had again been robbed from us. Millions of ideas ran through my head, losing my husband, losing our apartment, many more hospital stays, telling Tori the sad new, the impact that it would have on her, these are just a few of the things that raced through my head after were told the heart breaking news.

The neurosurgeon in the emergency room still wanted Travis to see Dr. Adler for his 9:00am appointment. I hugged Travis and smiled at him. Not because I was happy but because I felt so helpless. I wanted to take all of this away from him but I could not. All I could do for my husband at that time was to be as strong as possible for my husband. At this point I kind of felt like a zombie; I think I was in shock. I felt like crying and I felt empty inside but I held myself together and carefully wheeled Travis to his appointment with Dr. Adler.

When we met with Dr. Adler he advised us that he reviewed the MRI of Travis’s back and discussed the images with the head of Radiology. Together they agreed that what was seen on the MRI was not a tumor. During surgery some blood had leaked down Travis’s spine and collected. The collection of blood was pushing against his spinal cord and this was the cause for the pain Travis was having. Dr. Adler explained that over time the collection of blood would be broken down by the body and Travis would be back to normal. However, he wanted Travis admitted to the hospital to get his pain under control.

Before we left Dr. Adler’s office an assistant removed the staples from Travis’s head. We did not get an exact count but there were about 40. After his staples were removed we were told to go downstairs to “Patient Admitting” and that by the time we got down there orders would be in the system.

We went downstairs to Patient Admitting, the lady behind the desk told us that she did not see anything in the system for Travis; she recommended that we return to the emergency room so that Travis could be admitted that way. It was not a surprise when we arrived back at the emergency room and they did not know what to do with us. They checked their computer system which showed that Travis was still in the emergency room. After we explained to them the entire story they found Travis a bed in the hallway of the emergency room to wait in until they could admit him into the hospital. By this time we had been up for over 24 hours and at the hospital emergency room for over 12 hours with little rest and nothing to eat. I spoke with the nurse about getting Travis some pain medication. Once Travis was comfortable I left to get us some food.

It was a good thing I got us food because Travis did not end up getting put into a room until 5:00pm on Monday July, 23rd. (We got to the hospital at 10:00pm on Sunday July 22nd.)

Once Travis was put in his room he was pumped with lots of pain medication and had frequent visits from doctor’s and nurses. The plan was for him to get his pain under control. This was going to be done with the help of pain management doctors. Travis was hooked up to a pump. The pump had a button that Travis could push when he felt pain. The button would release Dilaudid and he could be administered the medication as frequent as every 10 minutes. Once Travis was hooked up to the pump it took a few button pushes before his pain was relieved. Within an hour Travis was feeling a lot better. The pain management doctor explained that the amount of times that Travis pushed the button on his pain pump would be factored into “recipe” for Travis’s pain medication.

I was relieved to see Travis feeling so much better. Within a few hours he was out of bed, moving around, straightening the room, and even shaving. My Travis was back. We spent a few more days in the hospital while they monitored Travis. Unfortunately the hospital could not get me a bed so I slept with some blankets on the floor next to Travis. One night we tried to share his bed but it was way too uncomfortable.

On Travis’s 4th day in the hospital the pain management team came in and told us that Travis was going to be released. They came up with a combination of medications that they felt would work to take away his back pain. They sent Travis home with the following medications to be taken every six hours: 2 Oxycontin, 800mg Motrin, 975 mg Tylenol, 1000mg Neurontin. He also was to wear a Duragesic patch that was to be changed every 72 hours. The combination of these medications took about 95% of Travis’s pain away.