The rapid spread of the omicron variant has created moving pockets of access problems throughout the U.S. health care system as more providers test positive for COVID-19 and child care issues and other secondary impacts lead to widespread absenteeism in some areas.
MOAA is working for you in the short term to address these pandemic-related challenges with the Defense Health Agency (DHA) and TRICARE managed care support contractors. We also continue our long-term efforts to ensure the military health system (MHS) remains solid as MHS reforms progress. Recent access challenges have underscored the need for surge capacity to allow the MHS to meet both its readiness and beneficiary care missions, and we are taking that message to the Hill as we continue our efforts to halt proposed medical billet cuts.
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A retired Army officer and MOAA member shared his family’s experience with access challenges – they are enrolled in TRICARE Select and use civilian care in their local community. While he and his wife have had no problems getting appointments, both routine and urgent, as well as timely prescription renewals and lab work, they’ve had an entirely different experience at his kids’ pediatric practice.
The practice recently experienced widespread staff absenteeism related to child care issues. Appointment line hold times have exceeded two hours, and parents were urged to reserve the phone option for families with sick children. Replies to online requests took several days, and routine appointments were being deferred. After waiting two weeks, his wife tried again and was able to get through and schedule an appointment without issue.
Both the civilian and military health care systems are grappling with COVID-19 related staffing shortages. The military health system has the added challenge of uniformed medical provider deployments – last month, another 1,000 military medical personnel were sent to assist civilian hospitals overwhelmed with COVID patients.
Another MOAA member and retired U.S. Public Health Service officer reported problems seeking care at her military treatment facility (MTF). When she arrived for an appointment, the clinic was virtually empty. The provider said the internal medicine department had been “wiped out” with staff COVID cases after seeing a COVID-positive patient.
[RELATED: Millions of TRICARE Beneficiaries Left Out of COVID-19 Test Reimbursement Plan]
Our member subsequently ran into delays getting a prescription renewed: She made the initial request during an appointment with the provider and had to follow up with multiple phone calls and secure messages to get the renewal sent to the MTF pharmacy.
Facing Care Challenges
MOAA is meeting with DHA and the TRICARE contractors to provide feedback from members and discuss the steps being taken to ensure beneficiaries can access needed medical care in both the direct and purchased care systems.
A few reminders to help you navigate the MHS during these COVID-related access challenges:
- The patient advocate at your MTF can help if you encounter problems accessing time-sensitive care at your military hospital or clinic, or have trouble getting a timely referral to a civilian provider.
- Referral-free urgent care, a legislative win in the FY 2017 National Defense Authorization Act, is available for active duty family members, retirees, and their families and survivors.
- The MHS Nurse Advice Line provides health care advice, help with finding an urgent care facility, and recommendations on the most appropriate level of care.
- We urge MOAA members to check their medications for refills and expiration dates – whether you see a civilian or military provider, it may take more time than usual to process a prescription renewal.
Your experiences help inform our advocacy efforts – if you have an access challenge to report, please contact us at legis@moaa.org.
Have More Questions About Your Health Care Benefit?
MOAA's TRICARE Guide answers some commonly asked questions.