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  #21  
Old 5 May 2018, 23:05
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TRY this link it talks about the change's for Tri-Care

http://links.govdelivery.com/track?t.../04_12_18_QLEs
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  #22  
Old 6 May 2018, 07:27
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Tri-care, Medi care, Social Security, and VA. You just retired, then you are no longer on the front burner. Welcome to the matrix of government frustrations !
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  #23  
Old 6 May 2018, 07:34
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The entire bureaucracy that is TRICARE is a cesspit of waste and abuse, just like the VA.

Far better to issue something like a restricted debit card that can only be used at medical providers and then let the recipient make choices about their own care. If we are serious about covering these costs, then just cover them. >95% will make good choices. When you can prove that the <5% are not just making poor choices, but actually defrauding the government, hang a few and you'll still be better off.

Paying this huge bureaucracy to make it impossible for anyone to make a poor decision is more wasteful than the poor decisions that will be made.
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  #24  
Old 6 May 2018, 08:07
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How about a card that is good nationwide for Retirees/ Combat wounded ETC that is universally accepted by all HC providers. Do away with VA completely and allow TRICARE to remain as necessary.
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  #25  
Old 6 May 2018, 09:47
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Quote:
Originally Posted by gavin View Post
I just retired.

I was unable to enroll in TRICARE Online, because the multi-million dollar website isn't functional, and all of the support phone numbers go into a loop and eventually cut the call off. I have wasted a significant amount of time trying to use the website, or dealing with the dysfunctional online tech support, which will not allow me to speak to an actual living organism.

Taxpayers are spending millions of dollar for this system that doesn't work.

I ended up having to enroll using a paper form, and snail mail.
In 2002 when I came back from the commercial world to a government contract job with military healthcare (.com bubble burst/etc) Tricare Online was the next big thing that was going to revolutionize DoD healthcare.

Being retired military I figured I'd give it a spin. Now, I worked in the .com world for 5 years as a consultant so this wasn't my first time around a website. After spending 15 minutes on the site and still not having reached the point where I actually had an account set up, I gave up. I said then that TOL is a waste of time. Looks like it hasn't changed much in 16 years.

It's unfortunate that so many things the government does are so burdened with regulation that they become unusable.
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  #26  
Old 6 May 2018, 10:58
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When TRICARE was first introduced (some point in the late 90s), I was at Fort Bragg. All green-suiters had to attend a presentation/briefing on TRICARE. Remember, when TRICARE first came out, it was for dependents. AD folks were still covered by Uncle Sugar.

It was one of those briefings that spouses were "strongly encouraged" to attend, but the mil member had to attend. So, got an auditorium full of mil and mil spouses. A couple of ladies were running through a slide deck on a projector (remember those?).

At one point, one of the ladies said words to the effect that TRICARE was going to be a vast improvement over mil-provided health care. Everyone in the auditorium burst out laughing. The TRICARE ladies became frustated, unable to understand why everyone was laughing.
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  #27  
Old 6 May 2018, 14:18
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Recent Changes
The following changes were implemented on January 1, 2018:
Changes
Overview
Accessing Care

Urgent care is now easier to access. There is no limit to the number of urgent care visits most TRICARE Prime enrollees can make without a referral. Learn more about your plan's details on how to get urgent care.
Health Plans

TRICARE Select replaced TRICARE Standard and TRICARE Extra.

Costs
Many cost shares (percentage of allowed amount) were replaced with copays (fixed amount).
You may need to pay an enrollment fee for TRICARE Select, depending on your plan and when you became eligible for TRICARE.
See your plan’s costs for more details.

Enrollment

You must now be enrolled for most TRICARE plans to get or change coverage.
If you were eligible for TRICARE Standard and TRICARE Extra on December 31, 2017, you were automatically enrolled in TRICARE Select.
Stateside Regions and Contractors


Learn more about Stateside Regions and Contractors.

The North and South Regions became the new East Region
Under the new regional contracts, the East Region is a merger of the North and South Regions and includes: Alabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa (Rock Island area), Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri (St. Louis area), New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas (excluding El Paso area), Vermont, Virginia, West Virginia, and Wisconsin.
.
Your regional contractor may have changed.
What’s Covered
We increased coverage for medically necessary
To be medically necessary means it is appropriate, reasonable, and adequate for your condition.
foods and vitamins.
TRICARE Select beneficiaries now have access to additional preventive care services without a copay when received from network providers.

Last Updated 2/9/2018
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  #28  
Old 6 May 2018, 14:22
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They could save a lot of money and just call all future programs "This years' way to get the soldiers to pay for more of their free healthcare"
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  #29  
Old 6 May 2018, 16:09
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Originally Posted by Gsniper View Post
They could save a lot of money and just call all future programs "This years' way to get the soldiers to pay for more of their free healthcare"
I use V.A. some, but have out side health care for my wife an my self. Over the last eight years (OBMACARE) the health care has gone up over $300.00 A MONTH.

What is driving the price in TRI-CARE up is OBAMA CARE. If the insurance company could go out side the state to provide care for anyone, then the price would go down.
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  #30  
Old 6 May 2018, 16:38
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TRICARE has morphed considerably, and no one was watching. Now, TRICARE is making decisions on care of active duty military members, decisions that affect readiness and combat effectiveness. TRICARE has zero oversight.

For example, a few years ago, I was an Active duty Special Forces soldier, and my military doctor prescribed custom orthotics, to be replaced every year. The yearly replacement is because the custom orthotics can't take the abuse of the mileage I was putting on, and break down. When the orthotics break down, they cease to be effective, and I break down faster.

TRICARE says "Nope. One-time prescription, no replacement." There is no appeal, beyond asking TRICARE "pretty please, can my military doctor take care of my active-duty military needs?"

That bothers me, a lot. We are allowing TRICARE, a non-governmental private business, to make decisions on medical care for Active-duty troops. Those decision are made based on one factor, cost.
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  #31  
Old 6 May 2018, 16:48
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Quote:
Originally Posted by wildman43 View Post

What is driving the price in TRI-CARE up is OBAMA CARE. If the insurance company could go out side the state to provide care for anyone, then the price would go down.
Tricare is broken down into regions not state by state.

Humana controls east region and Health Net Federal Services, LLC, the west.
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  #32  
Old 6 May 2018, 19:42
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Originally Posted by Silverbullet View Post
Tricare is broken down into regions not state by state.

Humana controls east region and Health Net Federal Services, LLC, the west.
I agree with you it is regions, BUT you have to read the small print sometime. Silverbullet, DOJ is catching the Doctors that are over charging the V.A. & Tri-Care false claims filed that a Veteran was never treated for. Who pays for it the Veterans in the long run. If you don't mine I will post just the web links of some of the cases in the Veterans Issues or General Topic area.
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  #33  
Old 6 May 2018, 21:06
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I read everything. Tricare is administered as I noted.
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  #34  
Old 7 May 2018, 01:43
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Quote:
Originally Posted by Silverbullet View Post
I read everything. Tricare is administered as I noted.
Sorry I left off the
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  #35  
Old 7 May 2018, 01:47
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Health Net


Tricare West contractor works to fix referral backlog, other problems facing military families
By: Karen Jowers   February 22


Defense officials are working with the Tricare West contractor to fix widespread problems affecting access to care for military beneficiaries. (File photo)
For the past seven weeks, Tricare beneficiaries in the West region have been facing widespread issues and frustration trying to get medical care.
Now, the new contractor is taking steps to address the problems, according to the Defense Health Agency.

https://www.militarytimes.com/pay-be...w-to-find-out/

Families are facing problems getting referrals to specialists. They also are having trouble finding area doctors and other medical providers that are in the Tricare network, they’re experiencing enrollment delays, and they’re waiting sometimes 45 minutes or more when they call customer service.
This has been going on since the new contract began Jan. 1.
“The DHA recognizes the issues with backlogs, call wait times and the number of provider choices

https://www.militarytimes.com/pay-be...icare-networks

for beneficiaries in the West Region. We are committed to working with Health Net Federal Service to resolve them in a timely manner,” said Ken Cannestrini, acting director of Tricare Health Plan, in a Thursday announcement from the Defense Health Agency,
“Service members, their families and others enrolled in Tricare expect the high standard of service we set for our contracting partners.”
The Defense Health Agency has been working with the contractor, Health Net Federal Services, to address the problems, officials said. For example, the agency is allowing Health Net to waive its usual authorization process for Tricare

https://www.militarytimes.com/pay-be...raise-co-pays/

Prime referrals in the West region, through March 18.
So, if beneficiaries get a referral from their primary care provider, they can download a referral and authorization letter,

https://www.tricare-west.com/content...val_Letter.pdf

then seek outpatient specialty care services that are covered by Tricare. These waiver approvals are valid for services received through June 15.

“That should eliminate a barrier to access to care that some families are facing right now, and we’re grateful for that,” said Karen Ruedisueli, deputy director of government relations for the National Military Family Association. “However, we hope that the Defense Health Agency is really putting the pressure on Health Net to put together an action plan and put every resource against fixing the rest of this. It’s been seven weeks now.”
Sweeping changes
As of Jan. 1, Tricare in the U.S. shrank from three regions to two. The geographic area of Tricare West didn’t change, but the contractor changed to Health Net Federal Services.
Tricare North and Tricare South combined to form Tricare East, with the contractor Humana Military, which previously had the contract for Tricare South.

The TRICARE West Region includes the states of Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (except the Rock Island Arsenal area), Kansas, Minnesota, Missouri (except the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (areas of Western Texas only), Utah, Washington, and Wyoming.
Along with the change in contractors, Tricare has undergone a number of other changes, including replacing Tricare Standard and Tricare Extra with a single plan dubbed Tricare Select.

New Tricare rules promise stability, but could raise co-pays
Some beneficiaries will be grandfathered into the system ... and that's not necessarily a good thing.
By: Karen Jowers
The process has been frustrating for patients and medical providers alike, and Military Times has received some complaints from military families.
In a post on Tricare’s public Facebook page, a referrals coordinator for an internal medicine clinic in Washington state said she had been diligent in providing Health Net with credentials and contracting information for all of their providers, well ahead of the Jan. 1 transition. But as of her post on Feb. 13, they’d been told that Health Net was behind on credentialing and unable to provide contracting information.
As a result, she wrote, “There are patients waiting to see oncologists, surgeons, etc., for LIFE THREATENING concerns that are forced to wait for referrals to be approved or see these specialists by paying for services out of their own pocket.”
She notes that when she calls to ask about referrals, there is a wait time of anywhere from 45 to 93 minutes.
Health Net has had to create a new network of providers and is having challenges building that network.
“We’re hearing from some people who say their provider network has essentially gone away in some areas,” said Ruedisueli.
“There are reports that there is no hospital in the network in their local area, and some have asked, ‘where did all the specialists go?’ “she said. “It’s hard to tell at this point how much of that is truly reflecting a network that has been decimated, versus they haven’t gotten the provider directories totally up and running.”

Working on solutions

Health Net is “working to improve the completeness and accuracy of [its] provider directory,” according to the announcement from the Defense Health Agency



The call volume at the contractors’ call centers for both the West and East regions has been overwhelming and far exceeded expectations, Ruedisueli said.
Beneficiaries have had questions about the new contract but also about the changes in Tricare, she said.
“Tricare did an abysmal job with communicating the news about the new co-pays, so people are being confronted at their providers’ offices, they’re getting bills in the mail, and there’s a lot of confusion about the new co-pays. Who’s taking the brunt of all that? Health Net, and Humana in the East.”
While the Tricare East contractor, Humana Military, had similar customer service issues, they’ve been able to react more quickly, she said.
In the West region, however, the problem seems to be snowballing, she said.
Health Net is hiring additional temporary staff and cross-training at their call center, according to the announcement.
There’s also an enrollment backlog, partly because of the required system-wide three-week enrollment freeze in December.
To address the enrollment backlog, Health Net is allowing beneficiaries in Tricare Prime whose primary care manager isn’t in the network, or who haven’t yet been assigned one, to see any Tricare-authorized PCM through March. 31. Point of service charges won’t apply.
“I can’t say we’re totally surprised by this, having gone through it with the United Health Care transition in 2013, but we were hoping for something that would be smoother,” Ruedisueli said
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  #36  
Old 8 May 2018, 22:39
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I had to deal with Tricare West once (2009). Nightmare. Then i did some digging around and found out that West was as messed up as a football bat. East has been fairly good to me. Only thing i hate about tricare is Express Scripts.
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  #37  
Old 10 May 2018, 12:32
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TRICARE Provider Types: Understanding Your Options as of 10 May 2018,

You can visit several types of providers when you need care, regardless of your TRICARE plan. It's important to understand your provider options because who you see impacts your out-of-pocket costs and filing a claim. Take command of your health and your TRICARE health care benefit by learning about your provider options

http://links.govdelivery.com/track?t...Provider_Types
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