The Tricare system needs a full review and overhaul. Our veterans and their families should be receiving the best care possible. Tricare is great if you’re a person who only needs a yearly checkup. However, if you have a chronic illnesses or special needs, the system seems to work against you.
For example: I have a T1D daughter. When our daughter was diagnosed, Tricare told us what glucose meter was covered only to find out, at the pharmacy, Tricare didn’t cover the device at all. We had to call Tricare again and found they told us the wrong one. We paid for the glucose meter but, 6 months later, turns out we were entitled to a free testing meter. No one at Tricare ever mentioned that to us.
We have had to spend hours fighting for things like needles or testing strips. Why? Tricare didn’t agree with how often our daughter needed insulin. When they finally fixed it, they ran her supplies through someone else’s Tricare coverage. We were able to fix it but it took 3 hours on the phone to do so.
We have argued repeatedly over copays for things like insulin. No one could answer questions or point us in the right direction. When we spoke with supervisors they were rude and treated us like an inconvenience. Ultimately, we had to involve congressman to resolve it.
We don’t have access to best in class care. Example: A new tubeless closed loop insulin system was released. Yet, military families were the last to receive coverage for it. Even though Tricare coverage states “any and all insulin pumps”. We even had a medical exception letter and, after being repeatedly passed back and forth between Tricare and ExpressScripts, we were still denied. Families (including myself) had to involve senators to push that forward. It was finally covered long after it being covered by other insurance companies including Medicare & Medicaid.
When you call with questions or concerns, each person gives you a different answer. The staff should be educated on how to support families when they call, what the policies are and what they are supposed to do to help move families through the process. Most of the people I speak with seem to lack the training to help anyone effectively. There is a feeling that, because they don’t have a competitor, there is no sense of urgency or incentive to do the right thing by our veterans or their families. I can’t imagine the amount of people who just give up. We can do better.