Posted on Apr 28, 2022
Sara Mantz
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My husband has orders for Hawaii; as of right now, the kids and I have been denied because of a behavioral health counseling that my son gets. The social worker recommends he goes once a month, but my son has been going once every two months without any problems. Do we get a second opinion, and do we also let the EFMP facility in Hawaii know that our son is on a waiting list for counseling at a doctor's office off base? Also, why are we getting denied if we know that we can go off base for the services that are needed for our son?
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MSgt Electrical Power Production
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You might be getting denied because the places off base may only have so many slots for Tricare patients, and they may be all filled. So, its not a matter of whether they do or do not have services, its whether they have the space/time to service you.
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SFC Ralph E Kelley
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I've done a lit' bit of checking and it sounds like its more of an availability of slots - that's if you did go through the military for his off-post care. If you didn't use the military for that reference, I am unsure how they found out about it since HIPAA and HITECH regulations should have prevented them from learning of his treatment.
In the meantime find and then provide the name of an off-post doctor along with a letter from him stating he will take your son as a patient. Add this to your request to accompany your husband. The alternatives would be to stay stateside or to leave him with family stateside while the rest of the family is in Hawaii.
I hope this helps.
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SFC Retention Operations Nco
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There is no appeal for EFMP. You can try again in six months. If your spouse is PCSing soon, he can contact his branch manager to change the orders, or if he reenlisted for them, he can renegotiate for a different assignment.
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