kids doctor martens Veterans blame TRICARE for higher co
JACKSONVILLE, Fla. Veterans enrolled in TRICARE say every day of 2018 has been a battle, especially for military families who have children on the autism spectrum, because of the abrupt change in their benefits.
TRICARE switched their contract to use Humana Military on Jan. 1. Since then, families say prices have drastically increased without any help or explanation and it’s leading to fewer service providers.
Providers say they aren’t being paid by the insurance companies and they don’t know where to submit claims because they can’t reach a customer service representative for information.
Families, like the Mercers, tell First Coast News they are having to decide if they can afford crucial treatments for their 14 year old son who has autism. He receives six therapies a week, with more expected in the future. Each time his mother has to pay a copay nearly triple what it was before the change to Humana.
“You have to really start thinking, can I afford this? Because it jumped from a $12 co pay to a $30,” Carla Mercer said.
She is a disabled veteran and her husband is a retired veteran.
“The jump in the co pays alone it isn’t just minor, it’s 100% more and then some.”
It’s not just the jump in cost that the concern, she says, it’s the lack of any explanation or documentation as to why.
“This morning I spent an hour and a half on the phone with TRICARE only to get that they said it’s on their website but I couldn’t find it, they walked me through every link but it just wasn’t there,” she said. “You’re having providers having to drop clients. If I walked in here and they said we can’t see your son anymore because we haven’t received any reimbursement, I think my heart will stop.”
Some providers say they are investing their own money to stay open since TRICARE hasn’t paid their portion.
One local TRICARE provider who is just as frustrated wanted to speak to First Coast News anonymously.
“We don’t know what’s going on, they don’t seem to know what’s going on,” the provider said.
She says she is owed thousands of dollars in claims just from this year.
“It’s a giant rabbit hunt, I call one number, I’m transferred, then I get hung up on. In some cases the wrong client is listed with the wrong provider so it’s a giant mess.
She says the company had two years to prepare.
First Coast News reached out to several representatives at TRICARE and Humana and explained the story would be airing on Tuesday evening. A representative responded later in the day saying they would send us their response to the allegations Wednesday morning.