Lack of coverage for our Armed Forces

Lack of coverage for our Armed Forces

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Sammara Rogan started this petition to Tricare

Hypospadias is the most common birth defect in boys. This defect means that the opening of the urethra is not located at the tip of the penis. Hypospadias is often paired with chordee, which is another birth defect that causes a curvature in the penis. Depending on the severity of the birth defects listed above, surgery is required. My son Terry Ollervides was born December 26th, 2018. When he was born, the doctors diagnosed him with hypospadias and chordee. As a parent, it was heartbreaking to heart that my sweet baby boy had a birth defect. It led me to ask myself if I did something wrong while I was pregnant. I was devasted. Tricare referred us to a pediatric urologist in St. Louis, Missouri. When we arrived at the appointment, my husband and I hoped that this was just a minor defect, no surgery required, but we were wrong. My sons’ condition was severe, the opening of his urethra was on the underside of his penis, very close to his scrotum. His chordee was also severe, later diagnosed close to an 80 degree curvature. We were told that surgery would be in our best interest, if left uncorrected it could cause sexual discomfort as an adult. My son would also have to urinate sitting down for the rest of his life, and cope with the fact his urethra opening was all the way on the underside of his penis. After that appointment, we did our due diligence as parents and researched for hours, days, months trying to find the best course of action for our poor baby boy. We were astonished by the amount of failure rates that occur from this surgery. We’ve read countless horror stories from parents about their son going on their 5th surgery due to lack of experience in surgeons. The question popped into our head: if you were getting heart surgery, would you want a surgeon that performs the surgery 10 times a year or 3 times a day 5 days a week? Easy answer for me, the surgeon who performs this surgery 3 times a day. After countless hours of research, we came across the surgeon Dr. Warren Snodgrass. He is an internationally known surgeon for developing the TIP repair, which is the most commonly used technique for hypospadias repair in the world. It is nicknamed the “Snodgrass repair”. He has over 39 years of experience, has published more than 150 articles, chapters, and authored textbooks on evidence based pediatric urology and hypospadiology. He has his own practice called Parc Urology, located in Frisco, Texas. His success rates are incredible. People travel from all over the world to him. I felt like we won the lottery when we discovered the king of hypospadias repair. His knowledge, statistics, experience, and success rates speak for themselves. When we contacted his office, we were informed they had to stop taking Tricare due to lack of payment. For example, Tricare would only cover 1 of 6 medical procedure codes required. Leaving Parc Urology to cover the rest. They would cover only one urethroplasty per 6 months, and only one tissue transfers a year. Based on that coverage, that would mean a one stage surgery has now turned into a 4-6 stage surgery, spanning over the course of 2-4 years. Parc Urology has tried multiple times to work with Tricare, but they told them that they aren’t a big enough organization to change their minds. With that being said, my husband and I were left with the option to take my son to the closest surgeon Tricare referred us to, regardless of his failure rates, or spend over 13 thousand dollars out of pocket to take him to the best surgeon. We had no choice ultimately, as parents we found the best surgeon, we couldn’t just ignore that or forget it. Our son’s health is more important than any amount of money. My son had his surgery on July 16th, 2019 and he is healing excellent. His second stage surgery is scheduled for January of 2020. We are now in the process of submitting a reimbursement claim with Tricare. The lack of coverage Tricare provided for my son is disgusting. The fact that Tricare is so uneducated on these saddening birth defects and the failure rates that are associated with it is disappointing. I expect the insurance that is covering the United States Armed Forces, to do their due diligence and refer patients to the best surgeon, not the cheapest. Society needs to stop turning a blind eye to poor health care for our military. This issue needs to be brought to light; Tricare’s coverage needs to change. Their ignorance in these birth defects is not acceptable.

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