Posted on Feb 23, 2020
DOD to downsize 50 hospitals & clinics; most will treat only active-duty personnel
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Posted 5 y ago
Responses: 3
This is another slap in the face for those who served. They already have a tiered system where things that are covered for AD are considered DME for retired. They more than doubled the copay a few years ago and will most likely continue to increase that cost. This year it’s $31 for any specialty doctor or walk-in clinic. They don’t control costs of the DME providers. They set a maximum daily allowed amount that they will pay whether it’s a hospital bed, oxygen tank, or in our case a continuous glucose monitor for our 12 year old son. The DME providers take advantage and change the max rate. So that it was cheaper for us to buy it at
Costco for $400 cash verses using insurance and paying 20% of the $3600 the DME is charging. Tricare doesn’t care to help and the DME attitude is you only have to pay it until you hit your catastrophic cap then it’s 100% covered. We tell them that kind of thinking is how we would ruin the service for everyone because Tricare would be overcharged and eventually pass that cost on to the clients. So I put effort to save Tricare money we pay the $400 and try to submit reimbursement claims. Humana/Tricare has continually denied the claims for not having a form they don’t list on the reimbursement process, then when we add it they accidentally cancelled the order, then they accidentally forwarded the claim to pharmacy benefits and denied it because it is supposed to be DME for retirees. Last we have submitted again and they denied because they sent it to the wrong area again. So the bottom line we have about $2400 out of pocket and hours of phone calls into Humana/Tricare supervisors and nothing to show for it. Moving everyone out to the economy is only going to make things a lot worse and force some of us that have chronic medical conditions to make choices on what condition will receive treatment this month. There has to be a better solution that trying to dump everyone into an already taxed healthcare system with no guarantees of available providers and cost control. These are detriments listed in their reports.
Costco for $400 cash verses using insurance and paying 20% of the $3600 the DME is charging. Tricare doesn’t care to help and the DME attitude is you only have to pay it until you hit your catastrophic cap then it’s 100% covered. We tell them that kind of thinking is how we would ruin the service for everyone because Tricare would be overcharged and eventually pass that cost on to the clients. So I put effort to save Tricare money we pay the $400 and try to submit reimbursement claims. Humana/Tricare has continually denied the claims for not having a form they don’t list on the reimbursement process, then when we add it they accidentally cancelled the order, then they accidentally forwarded the claim to pharmacy benefits and denied it because it is supposed to be DME for retirees. Last we have submitted again and they denied because they sent it to the wrong area again. So the bottom line we have about $2400 out of pocket and hours of phone calls into Humana/Tricare supervisors and nothing to show for it. Moving everyone out to the economy is only going to make things a lot worse and force some of us that have chronic medical conditions to make choices on what condition will receive treatment this month. There has to be a better solution that trying to dump everyone into an already taxed healthcare system with no guarantees of available providers and cost control. These are detriments listed in their reports.
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Another round of Pull the rug out from under those who were promised Health Care. Sad
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