National Eating Disorders Association

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activella
Tricare for Residential?

Hello,

This is my first post, and I hope it is in the right place. I was wondering if anyone has dealt with Tricare insurance when your provider has recommended residential treatment? I called Tricare to find out where my DD could go, and I was told "There is no list of places." I find this hard to believe with as common as eating disorders are. I have done some digging and have found some lists of Residential Treatment Centers, but they are not places just for eating disorders. Tricare does not seem to want to approve anywhere that treats EDs alone. I have found a few places that are "Tricare Certified" via searching the web, and the closest one to us is 13 hours away by car. We are in NC, and though there are RTCs in state, none of them seem to be on any type of approved list I can find. So I guess my question is, do you know of any treatment centers in NC which have been approved via Tricare? We are in the very beginning stage of the process, and I have been told things can take a long time to get rolling. I would just like to have some kind of idea where my sweet girl could be going, just for some kind of peace of mind I guess.

Thanks for your help!

michael26
Resources!!

Hello! Welcome to the forums and thank you so much for your post!! I hope that I can be of some help!!

I am glad that you have been working very hard to find your child a residential treatment center. I can totally relate to how difficult it is to get insurance to cooperate with accessing the care we need. Luckily, NEDA has a lot of resources to help!!

Have you called the NEDA Helpline yet? The Helpline staff are excellent at gathering resources related to certain insurance providers and are always there to help!! If you would like to have NEDA staff look into which treatment centers work well with Tricare, please call 1-800-931-2237! It is completely free!!

Have you looked at the information NEDA has on the website about insurance companies? Here is the link! There is definitely some information there that is helpful!

https://www.nationaleatingdisorders.org/insurance-resources

I hope this helps!! Please let me know if you have any questions!

AMoMof3
Just started this process

My daughter finally asked for help on Aug. 15th, so we started the process. She was recommended for inpatient and my husband is a retired soldier with tricare prime. She is currently in a hospital. If you can get your PCM and a nurse case manager to help naviagate the system. We did the same thing you are doing in the beginning and it was such a struggle. We were just about ready to give up, when I made an appt. with her PCM and when her EKG and pulse was bad and she is only 17 everyone started moving mountains for us. She has been in treatment for a month and has come to realize the damage she has done to her body. My advice to you, get someone in your hospital or doctors office to fight for you. They know what to say and do to get Tricare ot approve it. Good luck it is such a tough thing to watch your child go through this

smaes3
Advice needed.

We are in the same situation with Tricare. My Daughter is 19 and seeking a residential facility and apparently Tricare does not approve residential. There are amazing facilities here in Colorado but Tricare will not approve. Any suggestions or past experiences with Tricare would be very helpful. Tricare has approved an In hospital setting with younger girls 13-17. Neither of which we find acceptable. She does need to be medically stabilized and we feel a hospital setting would be very cold and she would be too old to relate to that age group. We of course would like for her to be in state but they are telling us we do not have any other options but the Hospital setting they offered.
Thank you.

Jerry.a.hall
Residential

Did you ever make progress on getting a residential program approved? We are in the same boat. Our daughter is weight stable, but needs a place to address her underlying anxiety and OCD, so she can finally beat her anorexia. A hospital focused on weight gain is definitely not what she needs! We foun a residential program that looks promising, but it is freestanding. We plan on asking for it, then appealing when Tricare says no, to my congressman if necessary. Thanks!

activella
Over a year later, but I did

Over a year later, but I did want to provide some type of update. The process of approval did not take as long as I thought it did. It was about a month from the discussion we had with the therapist about her recommendation for residential treatment to admission. My daughter's therapist had a place in mind after doing some research and talking to her colleagues. She was informed by her colleagues that their patients with Tricare had their stays approved. Now the catch....it was classified as a Children's Hospital, but they had different buildings depending on the reason patients were there. One week prior to her admission to the children's hospital, she was admitted to our military hospital while she waited on a bed to come open. That whole process was really ridiculous. Anyway, she ended up staying at the Children's Hospital for 3 months. She was able to meet all of her goals and the entire stay was paid for. When we got the authorization, I believe it was for 5-6 months max and then before they approved anything longer, a review had to be done. She was about 4 hours away from home, in Virginia, during those three months, and I drove up to visit with her every weekend while she was there. I got to speak to her on the phone every day, but she was not allowed to have her cell phone. I would be happy to answer any questions you may have. My heart goes out to all of you. I've been there, and I survived, and so did she, even though leaving her there was the hardest thing I have ever had to do in my life....it was what needed to be done.

nchapman12
reasons

is a certified tricare provider.

_admin_moderator
The comments and content of

The comments and content of this post has been edited. Please do not post links to a treatment facility or to a particular form of treatment because NEDA cannot promote or endorse any one treatment facility or form.

Please visit: http://www.nationaleatingdisorders.org/insurance-resources for helpful information and for insurance resources

We encourage you to call the NEDA Helpline at 1(800) 931-2237 (Monday-Thursday from 9am-9pm EST, Friday from 9am-5pm EST) for more help and assistance.

Thank you,

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