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Tricare is a massive failure


QuiGonJohn

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My retirement began in late 2019. So I first started using Tricare Select in Jan 2020. It has been a huge headache and massive failure all along. The latest problem I am having is I decided I would go ahead and get the "no-cost" Annual Physical (Preventative Care Visit). For some reason, my doctor's office had me come in on 10/4 for a visit to "order" and then "draw" my labwork. They then had me come back on 10/11 to follow up, go over the lab results and do the actual physical. Now I look and based on Tricare's processing of these claims, I am being charged $32 for the second visit and $51.86 for the labwork (required for the Preventative Care Visit). So a total of $83.86 to get my "supposedly no-cost Preventative Care Visit". This is an outrage. I submitted Appeals in the Secure Message area for the EOB of the second visit and the EOB from the Lab.

Also, during the last week, I discovered that Tricare and/or Express Scripts are NOT crediting a charge for an antibiotic I was prescribed, (filled at Walgreen's and processed thru Express Scripts), towards my Individual Deductible. This is WRONG. I even looked thru all the material on Tricare and Express Scripts website about Pharmacy Coverage. And while they do say for "non-network Pharmacies" you have to fulfill your deductible before they pay anything, NOWHERE do they say that money you spend on covered medicines at network pharmacies will NOT apply towards your deductible.

I have written a letter of complaint to the Director of Defense Health Agency, Lt Gen Place. But I wanted to see if other people regularly experience such malfeasance in the way their claims are handled. And all this on top of instituting the darn "Enrollment Fees" in 2021. I originally choose SELECT because there were no fees unless I seeked treatment. I am so mad, I am ready to go postal.

DHA, Tricare and Humana are literally killing me. Because I always have hassles getting my claims processed correctly, I feel like never going to a doctor or getting care, because I don’t want to deal with the hassle. When you’ve managed to make people feel it’s more trouble to seek treatment and deal with insurance issues, than just suffering through health problems, you have failed.

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