- November 10, 2023
- Posted by: legaleseblogger
- Category: Related News
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Have you ever experienced the sense that your Tricare coverage, specifically Tricare West for me, is not as robust as it once was? Lately, I have observed a decrease in the number of healthcare providers in my area who are willing to accept Tricare. Additionally, those who do accept it seem to lack enthusiasm for the coverage.
Is it possible that the reimbursement rates provided to healthcare providers by Tricare are not competitive? Could it be that they are not compensating providers in a timely manner? These issues raise concerns about the strength and reliability of Tricare as a healthcare provider.
While I am generally satisfied with my Tricare coverage, it no longer feels like the premium service it once was. This shift in perception has left me wondering about the true nature of my coverage and whether it is meeting my needs.
In situations like this, AI Legalese Decoder can be a valuable tool for unraveling complex insurance terms and contract language. The AI Legalese Decoder can help individuals better understand their Tricare coverage and decipher the sometimes confusing and convoluted language used in insurance contracts. By using AI Legalese Decoder, individuals can gain a clearer understanding of their rights and protections under their insurance policies, empowering them to make more informed decisions about their coverage.
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As they say, Tricare is great, if you can find people that take it.
I have used Tricare for nearing 20 years since I retired. It has always been a struggle but now seems much better than at times in the past, but I also feel like it can be dependent on where you live. The reimbursement rates are based on the Medicare reimbursement rates and are a fraction of what is billed. Look at your EOB sometime and see what is billed vs what is paid. Not going to get into a philosophical discussion about what they charge being fair but Medicare rates are very low and that often leads to medical providers not wanting to accept Tricare.
My uncles a facial reconstructive surgeon and told me it sucks that itÔÇÖs hard for you to find people to take Tricare cause you deserve better care but when Tricare pays the same as Medicaid you arenÔÇÖt going to get many top tier doctors willing to take it.
Tricare is great for what it is. ItÔÇÖs not a rich personÔÇÖs medical care but itÔÇÖs definitely better than what 80% of Americans have.
EDIT: And if you think itÔÇÖs bad you should see how messed up health care/cost is for working class folks.
The *coverage* is the same as it has been for years, is fantastic compared to other private medical insurance plans.
The *provider network* is not so great, mostly because their pay structure is shit and therefore many doctors won’t bother with them.
TRICARE is the worst payer- on par with Medicaid. They pay, at a minimum, 1% under Medicare rates. Most are getting far under that.
They pay on time- industry average of 60 days.
The only reason why a provider accepts TRICARE is for the volume it brings.
Yes. It’s taken us months to find a mental health provider for our daughter, and even now it’s telemedicine and not in-office visits.
Tricare’s website listed like a dozen dentists in our area…10 no longer accept Tricare and one retired and closed the practice.
Finding places that accept Tricare is a nightmare, and if you call for help, they just direct you to the “find a doctor” part of their website. Then you have to not only search for yourself, but call each doctor and confirm they still accept Tricare.
It’s too good. A medical professional once told me the reason doctors don’t like it is because the gov doesn’t reimburse as good as other insurance and the docs can’t get away with as much.
I swapped from Prime to standard and it helped tremendously. Now I just go where I want, don’t have to rely on a primary care doctor to do a referral.
I have had zero issues with tricare for myself or my family.
When was tricare ever a premium service?
My family has been on prime ever since I joined 9 years ago and weÔÇÖve never had any issues. I think it definitely depends on where you live. IÔÇÖve been hesitant to switch to standard because of issues like this though.
Tricare Remote…. Best coverage EVER
I just filed a congressional against Tricare for not providing medical records to claim VA benefits.
I’d gladly pay a higher premiums (still not what most pay though) if the network improved or appointments were easier to get.
That said, DOD shifting many retirees and dependents onto community care without providing required funding was a bunch of crap.
I think it depends where you live.
WeÔÇÖre Tricare west as well. I had a cardiac surgery done in 2018, fully covered had a referral from an on base provider, and they just reprocessed the claim last month and said they werenÔÇÖt covering the surgeons fees. I spent a full day going back and forth with the hospital/Tricare/patient advocate and i think itÔÇÖs been resolved.. but then i just got another bill added to my portal last night ƒÿÉ
We drive 45 minutes to an AF base for all medical care, thereÔÇÖs only two offices that take tricare in our town and theyÔÇÖre never accepting new patients.
Providers who participate with TRICARE canÔÇÖt bill you any more than TRICAREÔÇÖs allowable, either. So if they feel the CMAC rates are too low, they canÔÇÖt bill you for the difference between what they charge and what your payer says they can. This right is protected by law, as well.
Providers who participate with TRICARE canÔÇÖt bill you any more than TRICAREÔÇÖs allowable, either. So if they feel the CMAC rates are too low, they canÔÇÖt bill you for the difference between what they charge and what your payer says they can. This right is protected by law, as well.
I live in Corpus Christi – which is a “military town” having the CCAD and fixed wing finishing school for the Navy & Coast Guard, and even here it is difficult to find providers. I work for a Medicaid MCO – and providers tell me that TriCare pays less than Driscoll Health Plan and is a bigger pain to deal with/requires jumping through so many administrative hoops that it’s just not worth it – so they limit their panel size/TriCare patients they are willing to accept. There’s no behavioral health available – the two counseling groups that were taking it no longer do – unless you want to do telemedicine/virtual visits.
See- this is so odd to me. A few years ago, I worked at a physical therapy clinic- and the doctors loved Tricare- it payed out double what Medicaid did. I also had no problem finding providers for myself. This was in a small town in California.
Now I’ve moved to a bigger city in the south and I can’t get my son into a dentist office or anywhere because no one wants to accept Tricare here.
I wonder when it changed.
Tricare East here and they pay $30 less than Medicaid..they are officially the lowest paying in the entire panel of insurance companies we accept. This may be the reason sooo many people are dropping them! Awesome military support Humana ƒæŃÅ╝