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/.

Now that he is retired ( I have to catch you up with that on a later post) we decided it would be best for him to see a new pain management specialist. Travis decided to try Dr. Moon as he was recommended by our neighbor. Dr. Moon suggested that Travis start tapering off his Neurontin. This began on 5/9/09. Dr. Moon gave Travis some 300mg Neurontin so that he could start weaning himself down with a 600mg dose instead of a 1000mg dose. That was going very well and Travis seemed to tolerate the lesser dose. That was until Travis miscalculated how many Methadone he had left. On Travis’s 5/9/09 appointment he told Dr. Moon that he had enough Methadone to last until his follow up appointment on 5/20/09. Well Travis made an error counting the pills and he was short. So Travis cut his Methadone doses in half and went from taking 10mg daily to taking 5 mg daily. With the Methadone taper, Travis seemed to experience more irritability, stomach upset, and all over achiness.

On 5/20/09, I accompanied Travis to his appointment with Dr. Moon. At this appointment Dr. Moon prescribed 500mg Vicodin to use in place of his Methadone. He also suggested that Travis continue to taper off the Neurontin. He suggested that Travis be completely off the Neurontin by his next appointment which is in 4 weeks. Dr. Moon advised us that there will not be any Withdrawal from the Neurontin but the reason that Travis cannot stop “cold turkey” is because that could cause a seizure. So week by week Travis will be taking less Neurontin until he is completely off.

Travis is having a hard time with the Methadone Withdrawal. He was given the 500mg Vicodin to help him comfortably phase off. Our goal is to get Travis medication free by about 4 weeks from now. At that point Travis’s body will have an opportunity to feel what pain and discomfort is actually occurring naturally. Dr. Moon said that he has some patients who actually feel better off all medications. Once Travis is off all of his medications and Withdrawal free then we will explore other option of pain control.

Until then I will attempt to keep a brief daily diary of his medication consumption and the symptoms that he is feeling on that day. I believe doing this will help Dr. Moon see an accurate picture of what Travis’s has been dealing with and I also think the information will be useful for the website. I will try and update daily, here is what I have so far:

5/21/09
AM- Woke up with a stomach ache. Feels “groggy”, more tingly in face and chin.
1 Pepcid (7:00am)
600mg Neurontin (9:00am)
500mg Vicodin (9:00am)

MID-
600mg Neurontin
500mg Vicodin

PM- Sleepless night
600mg Neurontin
500mg Vicodin

The Feres Doctrine,I probably read about it on high school but I don’t remember.  Now, years later it is haunting my family as well as many other military families. (Taken from Wikipedia) …Feres v. United States, 340 U.S. 135 (1950), is a case in which the Supreme Court of the United States ruled that the United States is not liable under the Federal Tort Claims Act for injuries to members of the armed forces sustained while on active duty and not on furlough and resulting from the negligence of others in the armed forces. The opinion is an extension of the English common-law concept of sovereign immunity.

The practical effect is that the Feres doctrine effectively bars service members from successfully collecting damages for personal injuries, whether or not they were suffered in the performance of their duties. It also bars families of service members from filing wrongful death or loss of consortium actions when a service member is killed or injured. The bar does not extend to killed or injured family members, so a spouse or child may still sue the United States for tort claims (such as medical malpractice), nor does it bar service members from filing either in loco parentis on their child’s behalf or filing for wrongful death or loss of consortium as a companion claim to a spouse or child’s suit.

What is basically means to us is that because my husband is active duty, he is required to seek medical treatment from the military, and regardless of the outcome of the treatment, the military is not financially responsible.  The military can make any sort of careless mistake with his medical care which can result in death or permanent damage and we cannot file a lawsuit.  We are not looking to profit off of the unfortunate diagnosis my husband received.  However, the fact that he did not receive proper treatment which resulted in a subsequent brain surgery and eminent premature retirement does not seem right. How does it seem fair that because the military messed up they are pushing my husband out of the service?  My husband is not well enough to work and he faces multiple future surgeries and other medical treatment. Because he is going to be forced into retirement he will receive a significant cut in pay.  How are we supposed to make up for this pay cut?  I must return to work, which I have no problem with but who is going to drive him to his medical appointments and take care of him during the day following his surgeries if I have to return to work to financially support our family?

Now I understand that once you join the military you give up a lot of your rights.  However, how is it that convicted criminals…murders, child predators , and others on death row have more rights than those serving and protecting our country?  People in prison have a right to file a malpractice lawsuit but people protecting our freedom do not?  That does not make sense to me.

It is sad and very alarming that we are not the only family affected by this.  If you search the Internet there are many service members who are haunted by the Feres Doctrine. Below are stories of some others:

http://forum.rscnet.org/archive/index.php?t-127565.html

Sgt. Carmelo Rodriguez

http://www.gather.com/viewArticle.jsp?articleId=281474977247314

LT Clark and CDR Lamoreaux  

On Feb 18 1996, LT Clark and CDR Lamoreaux died in an explosion caused by a GE engine defect the Navy brass knew about but chose to ignore. The Feres Doctrine prevented their widows from suing GE for wrongful death. Feres is a license to kill our own service members.

http://sandiego.indymedia.org/en/2004/05/104505.shtml 

(spouse) Alexis Witt

“I have just taken my husband off life support at Travis AFB David Grant Medical Center. He had a routine appendectomy performed, he went without oxygen for 12-15 minutes after surgery because the staff tried to revive him with pediatric equipment…. many other mistakes were made that contributed. You can read about it online with the Salt Lake Tribune. ”

sincerley alexis witt
alexiswitt@hotmail.com

SPC Richard Jackson

“My husband is currently in the United States Army. He loves his country and is now getting medically chaptered out because of an acident he was in on October 22,2002. While he was loading a round into his tank while at gnnery, the new AIMS device caught him in the side of the head and crushed his skull. When he went into surgery 2 days later, he had both of his eyes working, undeleivibly. The doctors from BAMC hospital came out to tell me that while the surgery was successful, my husband is now permantly blind in his right eye and woudl never fee the side of his face again. The eyesight was lost because the docotrs went in too soon and caused severe sweeling. This was told to me by the doctors, they addmitted the fault. Now my husban who was a career soldier is being put out. He has nop other job skills then driving tractor an trailors, and that is not advises or leagal wih one eye and when we spoke to a lawyer they said nothing could be done because of the “Feres Doctrine”. Where are the rights fr the soldiers and there families. What help will we recieve now that he has to start over. What compensation is out ther for the families that have been hurt and whowill take the people rsposible to task for what they did? This document is a farce and it is fr the government to hide bhind. My husband gladl would give his life for his country beause he believes in it. Now the government wont help him. If anyone knows anything that can be of help please let me know and I will gladly help anyone who needs it. ”
Alexis and Spc Richard Jackson
Ft hood Texas
jaxkitten24@aol.com

(mother) Dorothy L. Bundrant dbund65371@aol.com

“FN Darion A. Price USN, KILLED MY SON, Cpl. Andrew R. Franco, on April 1, 2001, our Government knows and does not care. It happened on the USS Portland, during routine training. The sad thing is I believe my son was not the only one that died during that 6-month training.

        My name is Dorothy L. Bundrant. My 25 year old son is/was a Marine. My son, CPL Andrew R. Franco Jr., fell 25ft through an open hatch on the catwalk, which was carelessly left open by FN Darion A. Price USN, on March 29, 2001. My Son was in a coma for 3 days in Ramstein, Germany; while Andrew’s father and I were waiting for the Marines to obtain all the paperwork needed so that we could be with our son, he died, it was April 1, 2001. We never had the chance to tell him that we love him, or to say goodbye.

        At any other time this incident would be called negligent homicide or wrongful death but because my Son died in the military it was called a safety issue. WHERE IS THE JUSTICE that Andrew’s brothers, Father and I deserve? To my knowledge FN Darion A. Price USN has never once shown any remorse for his actions that caused my son’s death. He definitely never told my family or me that he was sorry.

Because it happened in the military both FN Darion A. Price USN and our government are immune; we will never receive the justice that we deserve”

http://www.kimmiecares.com/

Kim Goebel lost her battle to breast cancer but before she did she created dolls that can be used to help explain cancer to children.  Here is a description from one of the dolls:

“Kim is Causasian. She has blond hair, blue eyes and a nice smile. She likes to go wherever you go, and do the same things you do. Kimmie will always be your friend. Kim arrives with a colorful 35 page illustrated storybook titled, “Mommy and Me..taking care of each other”. She also has two different removable wigs, one with longer hair like Mommy’s before her treatment, and another shorter wig with curly hair, like Mommy’s hair when it begins to grow back. She even has a pretty pink scarf to cover your doll’s head, like Mommy wears when her hair has gone. Kim comes dressed in a pair of white shiny (easy to clean) pants, and a cute pink waistcoat that has a pink heart emblazoned with a Breast Cancer logo on it. The dolls are made of soft stitched machine washable fabric and should carefully line dry or hang to dry. Parental supervision is recommended for children under the age of 3.”

So to sum it up in the last three weeks we had a broken washing machine, broken refrigerator, and had to evacuate because of the fires just a day after we got back from Indiana. 

In less than a week we are getting on a plane again and flying up north to Stanford.  Travis is getting radiated.  I am happy that we have made it this far but the radiation is just a step in this process.  Only time will tell if the tumor is dead.  The radiation is an attempt to stop the growth of the tumor and to kill what is left after the surgery he had in July.  We will not know how effective the radiation is until months have passed.  Even if the radiation does it’s job Travis will still have to get frequent MRIs to confirm that the tumor has not grown.  Best case scenario would be for the tumor to die and Travis to only have to worry about his healing.

Travis’s healing is wearing on us.  He still has not driven since before his surgery.  His left eye is still “wonky”, he still feels ill, and his back is still in pain.  There is still a of recovery ahead of him.

One day I went to visit my grandma.  She asked me how I was doing and I told her I am doing my best to stay strong.  She shared the above prayer with me. I am not very religious but this prayer really caught my attention.  After I left my grandma’s house I kept thinking about what she had said and I went home and “googled” it so that I could find out more about it. I am so thankful that she told me this because every time things get tough I think about what she told me. 

You do not have to be religious to allow this to help you.  Just think of it this way, there are some things that you cannot change.  Instead of stressing over the things that you can’t change you need to stop and think about it.  If you can’t change it then accept it and find a way to live with it.  If the thing that is causing you stress is something that you can change, stop wasting time and stressing…DO SOMETHING ABOUT IT.

This is how I applied my grandma’s help to my life.  Obviously I cannot remove Travis’s tumor.  Sitting around being sad and depressed because he has it will only make matters worse.   I have learned to accept the fact that he has a Schwannoma tumor.  It is just a fact of life.  (That is the part that I can’t change.) I do have control over how I let this tumor effect our life.  Rather than be negative I do my best to see the positive side of it all.  I cherish every moment that I have with Travis and everyone else close to me.  I try and live my life to the fullest and not get upset about little things. (This is the part of my life where I change things.)

I kind of feel like this was a rambling post but the prayer is something that helps me everyday day and something that I think is very simple and can help so many other people.

Less than a year after his surgery he was told that the tumor grew back and was even larger than the original tumor.

His original doctors were unsure with how to treat him so we started researching his condition. He emailed numerous neurosurgeons. He found one that had a lot of experience with the particular tumor that he has. We then made phone calls and met with people at the hospital to discuss the possibility of a second opinion. We explained our reason for wanting the second opinion and a few days later we were informed that the request was approved. Arrangements were made and we traveled up north to meet with this renowned doctor.

The doctor’s many years of experience and confidence that he could treat his condition gave us so much hope. We returned home, made some more phone calls, met with more people and then we got the call. His treatment by this renowned doctor was approved.
We spent the next weeks planning for the trip. Now it is a few days away and we are almost ready to go.

This is our story…..COMING SOON