Navigating the complexities of military healthcare is a journey filled with
frustration, especially when it comes to addressing critical medical issues for our children. Over the past two years, I’ve experienced firsthand how these systemic inefficiencies can wreak havoc, and no one has borne the brunt of this more than my four-year-old son.
My son’s struggles with speech and hearing began early. He spoke late and early
speech therapy seemed to have no impact. Since his pediatrician never diagnosed him with ear infections, we didn’t initially consider seeing an ENT for tubes. It wasn’t until he was nearing three, still largely nonverbal and exhibiting behavioral concerns, that we pressed for other evaluations. Only then did the pediatrician refer him to an ENT, where we discovered he had been “hearing underwater” and desperately needed tubes to relieve the pressure.
After the procedure, we saw a slight improvement, but it didn’t last. A few months later, it became clear that his tubes had fallen out prematurely, and his hearing issues returned. At this point, we were on the cusp of a PCS (Permanent Change of Station). The ENT wouldn’t schedule another surgery because of the impending move, leaving us in limbo, where my son’s development stalled. His hearing loss and speech delays exacerbated his behavioral challenges, making social situations—like transitioning into a Pre-K classroom—incredibly difficult.
Adding to the stress, the base clearing process for our PCS required a family
medical clearance. Because of my son’s ongoing medical needs and referrals, our
case had to be manually reviewed. This process was a logistical nightmare.
Medical records from off-base providers created confusion, leading to our family
being dropped as patients too early. I made countless phone calls to obscure
numbers to keep the process moving after they had nearly jeopardized my orders
and our timeline to reunite with my husband after six months of separation.
The move also forced us to navigate the IEP (Individualized Education Program)
process twice. In Georgia, we had my son evaluated by the GA Department of
Education, which confirmed his needs. However, when we arrived in Maryland,
that evaluation was not honored. The county public school system disagreed with the assessment from Georgia, with their speech pathologist contradicting the findings of my son’s speech therapist. To make matters worse, we were told that even if my son had an IEP, it wouldn’t matter because he wouldn’t qualify for
public Pre-K in Maryland due to how services are allocated. Starting the process
over yet again was exhausting and disheartening, further delaying the help my son desperately needed.
Upon arriving at our new duty station, we had to start over with the medical
system. Establishing care with a new pediatrician, securing referrals, and
enduring another waiting game felt like being on an endless treadmill. Thankfully, this time, the system worked more efficiently. Within a few months, my son saw an audiologist and an ENT, who confirmed borderline hearing loss.
Five months after PCSing, he underwent surgery for a second set of tubes, along with the removal of his tonsils and adenoids. Finally, after over two years, we see significant improvements in his speech and occupational therapy.
But I am angry. I was furious that it took so long for his condition to be recognized and adequately addressed. Angry that moving during a medical difficulty stalled his care. Angry at the convoluted nature of programs like the Exceptional Family Member Program (EFMP), which is supposed to streamline support but often adds another layer of confusion. Military families should not have to fight this hard to receive medical services.
The constant moves, fragmented care, and bureaucratic hurdles create an untenable situation, especially for families with special needs. According to Military.com and a 2024 Pentagon survey of military families with special needs members, less than half were satisfied with the EFMP, and 57% were dissatisfied or had no opinion.
Despite its strengths, Tricare often falls short when care depends on referrals or
out-of-network providers—a fact that’s been echoed in countless testimonials from military spouses on platforms like Military.com and Blue Star Families surveys.
It’s high time for meaningful reforms prioritizing our service members' and their
families' health and well-being. Ideas like creating portable medical records,
expanding Tricare’s provider network, and automating referral approvals could
make a difference. While Tricare has made some progress in these areas, significant challenges remain. Portable medical records are still not universally accessible, and systems like MHS Genesis often fail to transfer seamlessly between duty stations, especially when care involves non-military providers.
The provider network is also limited in many areas, with families frequently facing long wait times or needing to travel significant distances for care due to a shortage of in-network providers. Finally, while aspects of referral processing are becoming more automated, Tricare still relies heavily on manual processes that can delay approvals, particularly during PCS moves or when urgent care is needed.
Addressing these gaps would significantly enhance the system’s efficiency and
accessibility for military families. Until then, we are left navigating a broken
system, hoping our voices will eventually lead to change.
As we look to the future, I can’t help but worry about what lies ahead. My son still needs ongoing care, and with another PCS expected in about two years, I
anticipate facing many of these same challenges again. Will his progress stall once more as we navigate new providers, referrals, and bureaucratic hurdles?
Despite these frustrations, we are fortunate compared to many families who endure even longer delays and more severe struggles. Their stories underscore the urgent need for systemic change in how military families access healthcare and educational support.
Emalee Mahr is a former intelligence professional who has provided full-spectrum intelligence support to military operations worldwide.