A retired Marine staff sergeant recently took steps to ensure he and his wife don’t lose their health care coverage after his allotment for Tricare payments was mistakenly stopped during the military’s transition to the new contracts in January.
Russ Clark is worried that other people have been affected, too, and could unknowingly be at risk of losing their coverage.
He’s concerned that other beneficiaries aren’t checking their pay statements from the Defense Finance and Accounting Service or their bank statements and could lose coverage if their allotment has also been discontinued.
“Others may not have noticed the allotment being stopped, as it was at the same time we got our [Cost of Living Adjustment] pay increase, so someone may be thinking that the increase in the monthly paycheck was just the COLA increase,” Clark told Military Times.
Certain beneficiaries pay for Tricare Prime, Tricare Select, Tricare Young Adult, Tricare Reserve Select and Tricare Retired Reserve plans. Clark pays for Tricare Prime coverage.
The problem came about during the Jan. 1 transition of Tricare West Region beneficiaries from the previous contractor, Health Net Federal Services, to the new one, TriWest Healthcare Alliance. Tricare officials repeatedly assured West Region beneficiaries who make recurring payments by allotment that their information would be transferred automatically.
That wasn’t true for Clark.
Clark’s December pay statement showed his allotment to Tricare was stopped. During calls to Tricare and DFAS, they “assured me that I didn’t have anything to worry about,” he said.
As of March 7, the allotment has yet to be restarted. He has been making payments online to ensure he maintains coverage.
“I will pay month to month until I feel certain that DFAS won’t start this allotment again,” Clark said.
In a few months, he plans to set up auto pay using a credit card.
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“We certainly apologize for any inconvenience caused by any issue with payment,” officials with the Defense Health Agency said in an email response to questions. “That said, this doesn’t seem to be a widespread issue, but for anyone who may be having issues with their payment by allotment ... check with your respective managed care support contractor.”
The contractors are TriWest Healthcare Alliance in the West Region and Humana Military in the East Region. Information wasn’t available from TriWest officials regarding the allotments, and DFAS officials referred the questions to Tricare.
Military Times heard from other beneficiaries who faced a problem with their Tricare payments that differed from Clark’s. They previously made Tricare payments by credit card and suddenly, allotments started coming out of their paychecks without prior notification — and without their authorization.
These problems are aside from those experienced by beneficiaries who previously made their Tricare payments by electronic fund transfer, credit card or debit card. Those beneficiaries are required to set up their payments with TriWest because the sensitive financial information can’t be transferred between the contractors.
But many of those beneficiaries have encountered problems setting up their recurring payments. So, Tricare extended the deadline to March 31 for beneficiaries to input their recurring payment information. Those who miss this deadline will lose coverage back to Jan. 1, Tricare officials have warned. Beneficiaries looking to update TriWest with their payment information should visit www.tricare.mil/west.
The transition to the new contracts has been a troubled one for many military families and health care providers. Families have experienced difficulties with setting up their payments, finding in-network health care providers and getting referrals and authorizations processed. They’ve also endured long wait times with the TriWest call center.
In the East Region, health care providers have faced problems with receiving reimbursements, putting some at risk of closing their doors. A number have dropped Tricare patients because of the lack of payments.
Tricare, TriWest and Humana Military have taken some actions to start to address the issues.
Karen has covered military families, quality of life and consumer issues for Military Times for more than 30 years, and is co-author of a chapter on media coverage of military families in the book "A Battle Plan for Supporting Military Families." She previously worked for newspapers in Guam, Norfolk, Jacksonville, Fla., and Athens, Ga.
