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EFMP (Exceptional Family Member Program)


Guest PistolPete21

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I know a guy...

A non-command sponsored dependent overseas is a nightmare. It will be the first question you have to answer with any DoD agency. All the privileges are different as you already know. Space-A, the money, but the worst: the medical.

Edited by addict
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di1630: re-attack! Sit down with your sq/CC and explain what's going on. If your story holds, and losing and gaining bases are good with your dependent, you can win this fight.

Get your wing/CC to get the NAF/CC to talk to the MAJCOM/CC.

Don't take no for an answer. For every rule there's a waiver or exception to policy...and this is the kind of fight you should win.

And if you're in AFGSC, PM me...I know a guy...

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Ahh, the great part of this is my chain of command is Army which makes it even more fun since all my EFMP is done at a AF base. So far not one suspense has been met by the medical community....on either continent.

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This could be easily doable. The EFMP process is risk averse to the point of absurdity. And the presumption that a bunch of mindless bureaucrats care more about the health of your dependent than you do is insulting. Most likely, they can't even find your gaining location on the map. Once you arrive, you'll likely find that there are thousands of American expats in country that are in no way connected to the US government and therefore without Tricare, etc. How are they surviving?! Your non-command sponsored dependent will have more benefits eligibility than you might realize. Read the Tricare documents closely and examine them from a mindset that your family is on vacation to the gaining country. I know of someone that was in a very similar situation. PM me for more details.

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Update: I asked my gaining rater for help in filing an appeal since the process has taken 90+ days already. He essentially told me that he didn't want to take a chance dealing with medical issues and within 12 hour canceled my assignment. Of course the only notice I got of the cancellation was an automated email.

sidenote: The guy is a non rated Col and I felt as if I was talking to a person with 1/2 his brain (no kidding)

IF ANYONE ON HERE EVER SEEKS MEDICAL ADVICE VOLUNTARILY....DO NOT!!!! My family got Q coded for a minor problem. The system is not designed to help you no matter what they say and decisions will be made by people who have never met you or your family or could give a Fck!!

I went from dream assignment to probable f-'d in 12 hours for subjective opinion on a cured minor condition.

Anyone is free to PM me if they need lessons learned or deals.

Or if you have advice, I'm still working all angles I know.

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is it possible that Tricare will auto-enroll someone based on medical situations?

Yes, and if you don't check your SURF for the Q code, you probably won't find out about it until you're ready to PCS, at which point you are well behind the power curve.

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How does one find out if they are Q coded? We have never filed anything to get the code, but is it possible that Tricare will auto-enroll someone based on medical situations?

Can also look at MyIMR/ASIMS.

To play devil's advocate for half a moment, a small minority of EFMP managers and doctors do care about the program and block assignments not from a fear of the dependent "dying," but because the level of care the gaining clinic will inherit will very possible overwhelm the system. Doctors frequently under perform because they are over burdened with administrivia and demanding work schedules. Every high utilizer literally worsens the already mediocre, red-tape-laden care care for everybody else. The capabilities of most overseas locals just can't support the same empanelment as a stateside clinic.

But for the great majority, yeah, it's a pointless career hurdle that does way more harm than good. I can't advocate outright lying, so perhaps exercise "big picture" logic whenever interacting with this program, it's questionnaires, or personnel. Of you are ever Q coded, be proactive to get it removed ASAP.

Posted from the NEW Baseops.net App!

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  • 5 months later...

I just got an OCONUS assignment and am currently working through the EFMP/overseas clearance process for my family. My son is enrolled in the EFMP and my wife is pregnant with our 3rd child.

All of our paperwork is near complete and is ready to be sent to the overseas location for review, but is being held up due to the pregnancy (she is due in two weeks).

Our coordinator at my current base is saying they need to make sure the pregnancy goes well before they start the coordination with my gaining base. Any truth to this?

It doesn't make sense to me to not at least start the coordination for my son who is the one in the EFMP and amend the paperwork when our baby is born. I am only a couple months out from training for the PCS and I am trying to lead turn this as much as possible.

With regard to my 3 yr old son, does anyone happen to know the capabilities at Ramstein? He is very healthy, but currently requires speech and physical therapy for his condition.

Thanks!

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Is it normal for a pregnancy to delay things? I'd look into the reg driving the delay for pregnancy and if not valid, elevate.

The EFMP process can be a nightmare. When I was entangled, I read the regs carefully to find out what was normal vs opinionated bs.

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Why is the EFMP office even involved? Lots of families PCS while pregnant without involving EFMP and with no issues. I can't see why they have a say.

I'd harass them to get the paperwork rolling for your son. My daughter's issue is minor (speech therapy) and it was still a pain in the ass.

I wouldn't expect any issues though. Even though my daughter wasn't in school yet she did speech therapy with a DODSS therapist at the on base school at Lakenheath.

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Thanks guys, did some more digging throughout the day and didn't find anything that supports what the coordinator has been saying.

I'm gonna press to test once more and if I get push back I'll elevate it, my leadership is in the loop and has my back which is nice, I'll repost what goes down in the end for anyone who runs into a scenario like this

Thanks again

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Unfortunately, I've had to deal with EFMP quite a bit, and still have to deal with it for a non-issue several years ago. Biggest lesson learned--if at all possible, never EVER have your families use the docs at an MTF if it can be avoided at all. Always use Tricare docs on the economy. It's a lot easier to hide their records from the EFMP that way. Any sort of mental health issue is going to you and keep ing you for years.

I can't speak to the pregnancy issue, but for your son, you have to ask a couple questions:

1. How badly do you want to go to Ramstein?

2. How much are you willing to pay out of pocket for your son's needed PT and ST? Keep in mind you'll be making a shit-ton of COLA over there.

If you want the assignment, start doing everything you possibly can to convince the Air Force that your son no longer needs PT and ST. Pay some docs out of pocket to write it up as such. Go to CVS or Walgreens for this if necessary.

Once you get to Ramstein, look for some PT and ST providers on the economy. German kids sometimes need them too, no matter what the USAF thinks. There are probably several spouses in the KMC that are certified in these fields and would love to do it for cash.

If you let the system run its course and you crawl through this EFMP shit tunnel, chances are good your son will be denied. USAF will tell you there aren't any/enough PT or ST providers in the Tricare network. It won't matter that you're willing to pay out of pocket. This is assuming the EFMP paste eaters aren't too lazy to look into it before stamping your son denied.

Another option is to do it all above board and when he comes back denied, say you want to take the assignment accompanied and get all approved family members added to your orders. Pay out of pocket for your son's plane ticket. He'll be covered under a different Tricare program and you may find that there are in fact eligible PT and ST providers. The trickiest part will be the residency, but I believe others on here have found workarounds. You might also check if he'd be eligible for the DoDDs schools, though I know some people that have sent all their kids to German schools for FREE. Good luck. Send me a PM for more info.

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  • 6 months later...

Does anyone know if March ARB (active duty side) is currently accepting EFMP folks? Specifically we need a Pediatric Cardiologist, and my understanding is there must be one at a MTF close by. San diego naval hospital does have one but its an hour and a half from there. Curious if anyone has dealt with this.

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Your best source of information is the EFMP office at the location, and if able, get in contact with the SGH at the facility to discuss your case. Also, tricare standard is worth some serious consideration.

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Sadly, you like have to do your own homework. As for the specialist, it doesn't have to be MTF (military). Some EFMP specialty docs don't exist in the mil system. In my area, we have a good children's hospital and folks go there for their specialty care. If you find a local civilian specialist, and they accept Tricare, and you make EFMP aware they exist, and the doc has space, the local clinic has the final say and convincing them may be a challenge. Be ready to lead everyone by the nose and push past the frustrations. This was my experience and I eventually got out of that program knowing me and the wife could do it better on our own. I likely have Tricare EFMP PTSD.

Good luck,

Out

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Does anyone know if March ARB (active duty side) is currently accepting EFMP folks? Specifically we need a Pediatric Cardiologist, and my understanding is there must be one at a MTF close by. San diego naval hospital does have one but its an hour and a half from there. Curious if anyone has dealt with this.

Not true. There must be a provider that takes tricare close enough to being in the vicinity of the assignment that they won't need to send you TDY to get care. That provider must also have openings. The find a provider page on the triwest website is your best friend. Get with your gaining EFMP office and provide them a list of providers at that location that suit your needs. When they coord it with the gaining base med grp, it'll give them ammo to say yes. CAUTION: Many of these offices are overworked and may just say no if there isn't the required specialist at the MTF.

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Not true. There must be a provider that takes tricare close enough to being in the vicinity of the assignment that they won't need to send you TDY to get care. That provider must also have openings. The find a provider page on the triwest website is your best friend. Get with your gaining EFMP office and provide them a list of providers at that location that suit your needs. When they coord it with the gaining base med grp, it'll give them ammo to say yes. CAUTION: Many of these offices are overworked and may just say no if there isn't the required specialist at the MTF.

Not totally true. Laughlin will have you drive 3 hours away to get care in San Antonio and not blink an eye. If your appointment is 1100 or earlier, you get to stay the night.

edit: for improper usage of "you're"

10-son-i-am-disappoint.jpg

Edited by sky_king
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^^^ that is true but there have been at least four in the OG that have PCS'd recently due to EFMP issues. It is really situation dependent. At my last unit my boss received orders to DLF and they CANX'D for EFMP.

Sent from my iPhone using Tapatalk

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Not totally true. Laughlin will have you drive 3 hours away to get care in San Antonio and not blink an eye. If your appointment is 1100 or earlier, you get to stay the night.

Copy. My language was not clear. Once you're already there, there's no problem with sending you out of town. They did that to us at Cannon for almost every medical need. That said, I've had assignments to good spots turned down for lack of 'local' specialists, even when I've known they exist. Due to the high human involvement, EFMP becomes a very individualized process, and not always for the better if the gaining unit doesn't want to go to the trouble of doing a little research.

EDIT: We eventually left Cannon due to EFMP. It's not all bad.

Edited by HU&W
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It looks like there are 20 pediatric cardiologists within 20 miles of March ARB. Plus a hospital 7 miles away that CAN do pediatric heart surgery, (not sure if I would choose to go there as there are better within an hour range) but that should help our case. The problem is that because it is a small base there is actually no EFMP office there at all. I called and the best they could do is give me a number to the med clinic. I am guessing this is going to be a long and painful process.

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