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.

We will be traveling up to Stanford for a follow up appointment with Travis’s neurosurgeon, Dr. Adler. We have to stay over night for that appointment and luckily my sister offered to take time off from work to watch Tori. With so much else going on I have not really had time to think about what we might hear from Dr. Adler. Travis is getting an MRI when he is up there and I hope that we get good news. To be able to function I have been thinking positive. In my mind Travis is on his way to getting better and we are on our way to living a more “normal” life. I hope that we are told that the tumor has not grown.

I have been doing my best to keep up with school. I was really looking forward to starting classes again but I did not realize how hard it was going to be to fit them in our busy schedule. More than once I have wanted to quit the classes because I feel so overwhelmed. What keeps me on track is I remind myself of special people like Travis’ Flight Surgeon and a few other individuals who have really made a difference in this difficult time. I want to be able to give back someday and I want to be able to help out other people and other families the way that we have. When I remind myself of these goals and of my mentors I get the strength to continue with my schooling. I am nearing the end of my first semester back and I can’t wait to finish so that I can feel that accomplishment. This last weekend I took three quizzes, one exam, watched a foreign film, wrote a two page essay, and read my textbooks. I could not have found the time for this if I did not have the support of my family.

Today we had plans to go to base to get our orders for our trip to Stanford. After getting our orders we were going to go grocery shopping and then to the bank. Well as usual, things could not go as planned. While we were at Travis’s unit getting his orders Travis bent down to fix his shoe and he had a back spasm. He described it to be just as painful as the time that he was hospitalized initially for his back problem. We finished up our business with his unit and then Travis drove to Base Medical. Why was Travis driving and not me? Well he just started driving again, he was driving his car and it is stick shift and I can’t drive stick shift. So we were stuck. Anyway, we made it to Base Medical and he was seen by the doctors that we on duty today. They assessed the situation and gave him some pain medication and a shot so that he could be comfortable. We walked down to the pharmacy and waited to be called. We ended up sitting next to a nice man that struck up a conversation with Travis. He noticed that Travis was in pain and started asking questions. One thing lead to another both Travis and the man were sharing there horror stories from Balboa Hospital. This man suggested that we write to our Congressman and Senator about what happened and gave Travis a great pep talk about standing up for himself. The pep talk really touched Travis’s heart to know that a stranger took the time to listen to what Travis has been going through and that this man actually cared.

Also I should mention that today Travis got a call from a stranger. When I use the word stranger I intend no negative connotation. I use the word simply to imply a person that has no relationship to us, someone that has no obligation to us. And it overwhelming to us when a stranger opens up their heart to us. Back to what I was saying, a woman called him today from the Injured Marine Semper Fi Fund. She got our information from a case worker and called Travis to tell him how her organization could help him. Something this woman said really touched Travis’s heart and after he hung up the phone with her he was speechless. I hate that Travis has had these health conditions but considering the situation, nothing could compare to the way that we feel when we are approached by caring people. It really means a lot to us. Nothing can take away his tumor but caring people can certainly make living with it a lot better. The feeling these people give us also is a motivation and a reminder of how important it is to give back.

Click here to read stories of injured services member and how the Injured Marine Semper Fi Fund assisted the service members and their families.

After an hour Travis’s radiation was done.  Travis’s neurosurgeon told us that he would like to see us in six months.  He also said that he expects Travis’s eye and jaw to improve over time but if it does not he could see a plastic surgeon.  Travis really enjoyed the mask he had to wear.  He asked his neurosurgeon to autograph it.  Then Travis wore the mask the whole car ride home.  Maybe this is the happy ending to a year and a half of worrying.

(click on the pictures to enlarge them)

We got a call from Travis’s neurosurgeon.  He explained to us that the reason two treatments are needed is because the residual tumor is very close to Travis’s optic nerve.  To be safe the radiation should be broken up into two treatments.  Travis explained to his neurosurgeon that we could not really come back for the second treatment and the neurosurgeon said that having one treatment on Friday morning and the second treatment on Friday evening would work out fine.

Not an hour later we got a call back from the neurosurgeon.  He asked Travis is he could come in”now” for the first CyberKinfe radiation treatment.  We told him that we would be there in 45 minutes or less, we were still in our pajamas when he called.  So we rushed to get ready.  I was excited because I want this tumor to be done with.  Travis started getting really nervous, even more nervous than he was for his surgeries.  I thought that this was odd.  He told me it was because he did not know what to expect.  On Tuesday we were given a DVD to watch that explained the whole CyberKnife process.  We had not gotten around to watching it yet. I suggested that Travis take one of his Ativans to help him relax.

By the time that we got to the hospital the Ativan had kicked in.  Travis was much more relaxed.  Travis was told to lie on the bed of the CyberKnife machine and they fitted the mask over his face.  He was given instructions to stay as still as possible and that if he needed to move (to sneeze, cough, or because he back got sore) to raise his hand and they would stop the treatment and help him.  I took a quick picture of Travis and then let the machine do it’s magic.

About an hour later Travis walked into the waiting room.  He looked like the same guy that I left on the table.  He said that he hardly remembered the experience.  He dozed off for the entire hour but was woken once when a technician offered to put on some music for him.
 

The first radiation treatment has been completed.  Now we have one more tomorrow.  I will try and get a couple more pictures tomorrow.

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.

The IV went in smoothly and Travis waited on the gurney for his turn.  They wheeled him in a room that had the CT machine.  They positioned him on the bed and made the custom mask which will be used to keep his head in place when he gets his radiation on Friday.  When they attempted to administer the contract for the CT Scan there were some complication with the IV.  Luckily the Ativan was working and Travis was pretty calm.  The CT Scan took less than 5 minutes.  After the scan they wheeled as back to a waiting area so that we could wait for Travis’s MRI. 

Dr. Adler (Travis’s neurosurgeon) came by to tell us that there was a “slight problem”.  They were not able to see Travis’s tumor on the CT Scan.  What a sigh of relief.  This does not guarantee that the tumor is gone forever.  What it does tell us is that it did not quickly grow back.  Dr. Adler said that he knew that he got a lot of the tumor out but it appears that the residual is smaller than he expected it to be. 

I will take this great news as an early Christmas gift.  Even though the appointment yesterday went well there was still a little bit of doubt in my mind.  The picture (CT/MRI) does not lie.  There was a chance that the tumor could have grown back like last time.  The fact that the tumor was not seen on today’s scan is a great sign. 

As we waited in the Radiation Therapy unit we had interaction with a lot of different doctors, nurses and Stanford associates.  It is rare when you come across ONE caring person in a day.  In this unit and the entire hospital EVERYONE here is so caring.  It means so much to be in such a comforting environment when you are dealing with medical hurdles.  The majority of life you are a number everywhere you go.  In a classroom, at the bank, at a restaurant, but here, they really make you feel like they care about you. 

Travis went on to have an MRI.  After the MRI we were instructed to return to the Radiation Therapy Unit.  When we returned we were told that they would call us to confirm the radiation appointment for Friday.  After a long day we were ready to go back to the hotel so that we could rest.

I will update again soon.