I have a friend whose 12 year this morning woke up with a fever and chest pain. Second time in less than 2 months. Her children see a civilian provider. She took him to the ER at Balboa this am and was told it was reflux and given a GI cocktail. His labs were drawn but really screwy and nothing was said to her. Also had an EKG done which showed a T wave abnormality (same thing it showed last time). She took him home and he's spiked another fever, is having chest pain still and she says that he doesn't look good. Can she take him to Children's ER and have Tricare pay for it? She really doesn't want to take him back to Balboa.

She can go to a civi er esp with chest pain...

Whats closest to her?

More then likely tricare will try to deny the charges. But if the childrens is closer she "might" be able to fight it. But its gonna be a risk because ER charges are NOT cheap and she MAY end up footing the bill

tricare covers emergency visits (in the ER) no matter what. tell her to take him ASAP!!!

I would say yes if they see a civi provider...she can take him to the hospital that their Dr. is affiliated with.

I always thought there's a mileage distance involved...
Unless of course it was a severe car accident or a situation like that...

Chest pains in most cases are Emergencies....Either way the child needs to go back..

she just needs to call tricare within 72 hours to let them know and it will be covered.


ETA~ my neighbor just did this with her foot. balboa er told her it was sprained. she went to sharp the next day and found out that not only did she break her foot, she tore several tendons. she called tricare before she went and they said it would be covered as long as a phone call is made with 72 hours of the visit.

I would take my child where the best care is regardless of cost. You can fight w/insurance later but the health of the child should always be put first IMO.

i AGREE... I'D BE PACKING UP THE BAG AND ON MY WAY TO THE HOSPITAL !!

I havent read all the posts in this yet. BUT has it been 24 hours since she has taken him in to the ER? Tricare will try not to cover it since usually for a follow up appointment you need to go to your primary physician. At least this is the way it was explained to us.

I havent read all the posts in this yet. BUT has it been 24 hours since she has taken him in to the ER? Tricare will try not to cover it since usually for a follow up appointment you need to go to your primary physician. At least this is the way it was explained to us.

This isn't a follow up though...this is his problem coming back and by the sound of what she stated it's worse

No it isnt a follow up but it is the same issue..... they would want him to be seen by his primary care clinic.. A LOT cheaper!

But no Dr or insurance company expects a true emergency to wait 24 hours

But no Dr or insurance company expects a true emergency to wait 24 hours

You are talking about Tricare!:lol

Tricare or not who the hell would have their child sit around w/chest pains?

Tricare or not who the hell would have their child sit around w/chest pains?

Obviously as a mom with a "few" kids.. I would have been there sooner then making a post...

I wouldnt care :lol

Is their a childrens hospital in the area?

I would rush my child in no matter what! Screw Tricare and their rules:nutts

Whoa ladies!! She is a mom of five kids, her DH is gone to Texas because his aunt who raised him just passed away and her son has been having this chest pain all day. She DID take him to the ER where she was told that it was heartburn and he was given a GI cocktail for it. It had not gotten any better and she was wanting to know if she had to take him back to Balboa or if she could take him somwhere else. Her Dh is getting ready to deploy and she works full time already and they can not afford to pay for an ER visit. She was a corpsman and is currently working in a medical office as an medical assistant so she's not stupid. She called me to let me know what was going on. She had just given him motrin to see if it would help bring the fever down and she was going to try to get some fluids in him. Obviously she realizes that chest pain in a 12 year old is not normal and she has taken the steps to care for him.