Complaint Review: Tricare

 Tricare, as a whole, along with Express Scripts, the pharmacy branch of the Military Benefit Medical Sham, refused my wife's specialist prescribed medication, even having test documentation, written medical opinions and a legal prescription.  While stationed in California, my wife was diagnosed with Central Sleep Apnea and Narcolepsy.  She was prescribed Nuvigil, a very expensive medication, costing $700 a month.  Additionally, she was prescribed another medication at the same time, of which I forget the name, that cost $400 a month, and was also repeatedly denied by Tricare for unknown reasons.  We lost sense of the whole matter, as every time we provided what they wanted, there was another hoop to jump through. 

We spent the $1100 a month out of pocket for just about 3 1/2 years total.  At the end of the California tour, by some miracle, both medications were finally approved.  That lasted about 4 months, until we were sent to Tennesse.  This is totally different "region" than California of the same overarching Department of Defense Healthcare program.  But, since it is run by individual contractors with the lowest bid in each region, the rules changed again upon our move, and the fight started over.

It took about 7 months and the intervention of the Tricare department at Fort Campbell to get one of the medications approved.  We had to continue to fight our own battle on the second again, and another 2-3 months later, began getting coverage again.

Everytime we have approached fixing our coverage, or requesting a reimbursement or filing a claim, Tricare will tell us that Express Scripts is in charge of those decisions, and after being transferred to Express Scripts, they tell us that Tricare is the decision maker, they simply send out what they are told is covered by Tricare.

Long story short, I am a senior Field Grade Officer with the credit rating of a crack addict because of this system.  Out of pocket, we have calculated in excess of $40,000 that we paid due to the incompetence or corruptness of our Federal Health Care system for the Military.  Obviously, contactors are going to try to save every penny, so I'm not surprised.  But, I am surprised that our own Government allows this to happen.  Every cry for help fell on deaf ears, until my last assignment, when my commander did everything he could to help us, resulting in the connection with Fort Campbell and coverage of one medication.

Financially, we haven't still fully recovered, as all the ankle biter loans we had to take out to stay afloat have added up, but after 3 years, it's getting better.  Our credit is completely demolished due to this lack of care and integrity in the system, and the lack of oversight and quality control.

Tricare is another government contracted catastrophe where the civilian entities are allowed to do anything they want and hurt anyone they want just like Blackwater did.  We all know how that turned out.

logoff290@gmail.com