Proudly Supporting all Military Families with a Special Needs Dependent
Last week, we asked our members stationed in the TRICARE West region about their experience with the recent insurance transition from TRIWEST to United Healthcare Military and Veterans. We have heard your concerns, and we want to assure you that we are seeking answers. Below is a letter that we have sent to the CEO of United Healthcare.
Proudly Supporting All Military Families with a Dependent
with Special Medical and/or Educational Needs
May 10, 2013
Mr. Stephen J. Hemsley, CEO
P.O. Box 1459
Minneapolis, MN 55440-1459
Dear Mr. Hemsley,
On May 1st, the Military Special Needs Network – a global, support network for military families with dependents with disabilities – asked members how the transition from TriWest Healthcare to UnitedHealthcare Military and Veterans affected them. The response was overwhelmingly negative. Families reported loss of services due to:
Shortly after the member poll, we contacted UnitedHealthcare Military and Veterans to establish a liaison between these families and UnitedHealthcare. A representative assured us we would receive a call back by the end of the day. This conversation took place over a week ago and that call has not been received.
It has been a year since UnitedHealthcare won the contract for the TRICARE West region and the lack of adequate, effective procedures has caused military families to lose necessary specialist services. This is a black mark on the United States’ military and, according to the Pentagon, UnitedHealthcare is to blame. (Miller, 2013). Dr. Jonathan Woodson, assistant secretary of defense for health affairs, states “UnitedHealth’s ‘failure’ has prevented a large number of beneficiaries in one Tricare health plan from obtaining timely access to specialty care” (from Miller, 2013). Many families select military orders near their specialists, only to be refused their expertise due to UnitedHealthcare’s failure to implement a system capable of handling the caseload. This is in breach of the contract military members sign upon enlisting wherein service members and their families are to be provided proper and timely health care.
Not only are beneficiaries experiencing extreme difficulties with UnitedHealthcare, but providers are suffering as well. Providers are not reimbursed in a timely manner and, in some cases, are unsure if they will ever be paid. As such, many providers are now turning away military families because they cannot afford to provide services without proper or timely compensation.
In short, the transition from TRIWEST to UnitedHealthcare was to be seamless, with changes being administrative only. This, unequivocally, has not been the case and military families are suffering because of it. This memo is meant to indicate the extent of the problems military families are facing due to this transition and to initiate what we hope will be an effective, beneficial dialogue between a UnitedHealthcare liaison and a representative of the Military Special Needs Network.
Wendy Kruse, Miranda Fort, and Kelly Hafer
Executive Leadership Team
Military Special Needs Network
Brigadier General W. Bryan Gamble, M.D.
Dr. Jonathan Woodson, Assistant Secretary of Defense, Tricare Management Activity
Senate Armed Services Committee Members
House Armed Services Committee Members
Miller, Kathleen. 2013. Pentagon blames UnitedHealth for delays in military health care.http://www.startribune.com/business/205892591.html.
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A site to discuss and learn about TRICARE Philippines Policies and Issues that are often times implemented in secret by the Defense Health Agency (DHA). Policies that result in payments at about 7.7% and 3.8% of what they should be or $328 per under 65 person instead of the expected $4,261 & $328 per over 65 person instead of the expected $8,650.
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