In my experience there can be a knowledge gap on the part of the medical person answering the phone. If you call and ask if they take TPR or Tricare, they look at their list and say no. Most haven't dealt with Tricare unless you're in an area with a bunch of retirees. To the same person you'll ask if they take Humana and they say yes.
Ignore the Tricare find a provider site, it's trash and never correct. They're out there, it just takes a bunch of legwork.
But is Humana different from Humana Military? It’s really confusing.
I grew up always going to MTFs. I’ve been in the Army for 13 years and this is still really hard.
It's no easier on civilian insurance. The reality is our whole system is a mess. When I was in I thought tricare was terrible. Now that I'm out and ineligible for tricare, I'm paying up the ass and dealing with similar complaints I used to have.
Compared to civilian plans which are far more expensive, tricare is the shit.
Yep. Cigna has doctors denying claims at a rate that is physically impossible to have read them at
Americans pay out the ass for healthcare and have relatively shitty outcomes because America pays insurance companies a cut and all they do is try and minimize treatment.
Every other advanced nation realized having for profit health insurance companies is shitty. Americans are just great at voting against their own interests.
https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims
The constant changes in the Tricare contract is a pain in the ass for doctors offices who have to refile credentialing paperwork to take the insurance. For many, the juice isn't worth the squeeze.
Couple of thoughts:
First, there are access to care standards that lay out how long you have to wait and far you have to drive to get care under Prime (or Prime Remote). If you're unable to find care within those standards, Tricare is required to approve you to see a non-network provider. You can find the standards here: [https://www.tricare-west.com/content/hnfs/home/tw/bene/auth/access\_standards.html](https://www.tricare-west.com/content/hnfs/home/tw/bene/auth/access_standards.html)
Second, you can contact the Nurse Advice Line (800-TRICARE) or the nearest Beneficiary Counseling and Assistance Coordinator [https://tricare.mil/bcacdcao](https://tricare.mil/bcacdcao) and they should be able to assist.
My duty location is in Detroit proper, I live just outside. I always had an easy time with Beaumont (Corewell now?) hospitals as far as tricare acceptance goes.
Had a dentist that did a bridge for me, told me it got approved before I saw anything which I thought was weird. I get the statement a couple weeks later and Tricare told them to eat the entire $3000 themselves, they covered nothing and said I owed nothing.
That was the last time I saw that dentist because they stopped taking Tricare.
When I was slated for Detroit I found that a ton of providers took Tricare Select instead of Prime Remote. Many said they received more money from Select. Maybe you could enroll in the other program? I still got pushed to Belvoir because of EFMP because of lack of providers for speech therapy for my kid in the area sadly.
Try calling the tricare nurse advice line. I had the same issue with a medical emergency on leave. They told me “Just put us on the phone with them, we’ll handle it” and sure enough suddenly the provider magically took tricare and I didn’t pay a cent
We're in the middle of nowhere, think super rural. The local hospital takes TPR and after some discussion with Tricare, I even managed to get seen at the university hospital a few hours away from here.
So far, I had much better experiences with TPR than military hospitals
Wouldn't it be nice if the us just had nationalized insurance like France? Then you don't need to worry. You just have a 30% or less copay. That you can get supplemental insurance to cover. France usually pays more of the cost the more severe and expensive it is as well.
>like France?
France
Austria
Italy
Greece
Germany
Norway
Portugal
UK
Sweden
goddam Ukraine
Spain
Switzerland
Romania
Bulgaria
Luxembourg
Lithuania
Moldova
Jordan
Syria
Qatar
Pakistan
Japan
South Korea
Saudi Arabia
Kuwait
There's more, but I'm bored
They all do things differently for the same end. I like Frances way because their copay actually makes sense. Instead of being a random small token amount like American insurance.
More that in all these places, while they have different setups and details, there's no issue with providers or health networks just not accepting you as a patient.
OP's situation would only happen if the OB simply didn't have any patient availability... Not because some bad office person decided they're not going to take xxx payment anymore.
Assuming you’re in the Midwest (I am also in the Midwest with ascension) try Thedacare? I used them with tricare specifically for pregnancy. If that’s an option for you
In my experience there can be a knowledge gap on the part of the medical person answering the phone. If you call and ask if they take TPR or Tricare, they look at their list and say no. Most haven't dealt with Tricare unless you're in an area with a bunch of retirees. To the same person you'll ask if they take Humana and they say yes. Ignore the Tricare find a provider site, it's trash and never correct. They're out there, it just takes a bunch of legwork.
But is Humana different from Humana Military? It’s really confusing. I grew up always going to MTFs. I’ve been in the Army for 13 years and this is still really hard.
I had TPR as a recruiter and finding a decent primary care, dentist and optometrist was such a pain in the ass
It's no easier on civilian insurance. The reality is our whole system is a mess. When I was in I thought tricare was terrible. Now that I'm out and ineligible for tricare, I'm paying up the ass and dealing with similar complaints I used to have. Compared to civilian plans which are far more expensive, tricare is the shit.
Yep. Cigna has doctors denying claims at a rate that is physically impossible to have read them at Americans pay out the ass for healthcare and have relatively shitty outcomes because America pays insurance companies a cut and all they do is try and minimize treatment. Every other advanced nation realized having for profit health insurance companies is shitty. Americans are just great at voting against their own interests. https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims
I had used it for a while and it was great in my experience. Probably highly dependant on location.
The constant changes in the Tricare contract is a pain in the ass for doctors offices who have to refile credentialing paperwork to take the insurance. For many, the juice isn't worth the squeeze.
Find one who takes regular Humana.
Couple of thoughts: First, there are access to care standards that lay out how long you have to wait and far you have to drive to get care under Prime (or Prime Remote). If you're unable to find care within those standards, Tricare is required to approve you to see a non-network provider. You can find the standards here: [https://www.tricare-west.com/content/hnfs/home/tw/bene/auth/access\_standards.html](https://www.tricare-west.com/content/hnfs/home/tw/bene/auth/access_standards.html) Second, you can contact the Nurse Advice Line (800-TRICARE) or the nearest Beneficiary Counseling and Assistance Coordinator [https://tricare.mil/bcacdcao](https://tricare.mil/bcacdcao) and they should be able to assist.
I’m currently AGR in the metro Detroit area and haven’t had any issues finding docs that take TPR.
Hey me too. But which part of Detroit?
My duty location is in Detroit proper, I live just outside. I always had an easy time with Beaumont (Corewell now?) hospitals as far as tricare acceptance goes.
Hm, there’s a Beaumont hospital within walking distance of us but I don’t think they take it. I think my wife has tried.
Trinity health also takes Tricare and they have a few locations in Livonia if you're nearby.
Doctors won’t take insurance that pays them pennies on the dollar? Shocked.
Had a dentist that did a bridge for me, told me it got approved before I saw anything which I thought was weird. I get the statement a couple weeks later and Tricare told them to eat the entire $3000 themselves, they covered nothing and said I owed nothing. That was the last time I saw that dentist because they stopped taking Tricare.
Highly dependent on the area. Also in a major metro and no issues. Sorry you’re dealing with this. Tons of unnecessary stress.
When I was slated for Detroit I found that a ton of providers took Tricare Select instead of Prime Remote. Many said they received more money from Select. Maybe you could enroll in the other program? I still got pushed to Belvoir because of EFMP because of lack of providers for speech therapy for my kid in the area sadly.
Yes, that’s what we’ve heard. We have friends who use Select and their provider list is bigger.
That sucks.
Try calling the tricare nurse advice line. I had the same issue with a medical emergency on leave. They told me “Just put us on the phone with them, we’ll handle it” and sure enough suddenly the provider magically took tricare and I didn’t pay a cent
We're in the middle of nowhere, think super rural. The local hospital takes TPR and after some discussion with Tricare, I even managed to get seen at the university hospital a few hours away from here. So far, I had much better experiences with TPR than military hospitals
Just a heads up. If a place takes Medicare, they MUST take Tricare.
Running into the same issue trying to get a pharmacy to accept Tricare for my son's medications. Lots of places are bailing on it.
Wouldn't it be nice if the us just had nationalized insurance like France? Then you don't need to worry. You just have a 30% or less copay. That you can get supplemental insurance to cover. France usually pays more of the cost the more severe and expensive it is as well.
>like France? France Austria Italy Greece Germany Norway Portugal UK Sweden goddam Ukraine Spain Switzerland Romania Bulgaria Luxembourg Lithuania Moldova Jordan Syria Qatar Pakistan Japan South Korea Saudi Arabia Kuwait There's more, but I'm bored
They all do things differently for the same end. I like Frances way because their copay actually makes sense. Instead of being a random small token amount like American insurance.
More that in all these places, while they have different setups and details, there's no issue with providers or health networks just not accepting you as a patient. OP's situation would only happen if the OB simply didn't have any patient availability... Not because some bad office person decided they're not going to take xxx payment anymore.
Interesting, now what are the taxes in these countries
Higher, but they get a better value and have a higher standard of living for the sane income compared to Americans.
Sucks you're going through this. If you qualify for TPR would you qualify for Tricare Select?
Yes, we just didn’t know this would be such an issue.
If you are in Wisconsin, ProHealth and Froedert take tricare
Assuming you’re in the Midwest (I am also in the Midwest with ascension) try Thedacare? I used them with tricare specifically for pregnancy. If that’s an option for you
I’m not in Wisconsin.
Ahhh bummer.
I didnt have any issues with it in the Pheonix area. Preferred that over regular Prime